Barriers to adherence to secondary prevention therapy in patients with ischemic heart disease: a cross-sectional study of a Mexican reference center.

Archivos de cardiologia de Mexico Pub Date : 2024-09-03 DOI:10.24875/ACM.24000034

José R Orozco-Moreno, Enrique A Berríos-Bárcenas, Dante Palacios-Gutiérrez, Alfonso R Aldaco-Rodríguez, Nydia Ávila-Vanzzini, Jorge E Cossío-Aranda, Claudia Cel Valle-Chávez, Mario Leyva-Balderas, José A Maza-Larrea, Francisco J Roldán-Gómez

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Abstract

Objective: This article aims to assess the adherence level to second-line therapy for cardiovascular prevention in a tertiary hospital in Mexico City and identify key barriers to adequate pharmacological adherence.

Methods: A single-center prospective cross-sectional study was conducted between August 2018 and February 2020. Sociodemographic data were collected, and the Morisky medication adherence scale was performed. Directed interviews during medical consultations were also conducted to determine reasons for non-adherence.

Results: Showed that out of 991 patients included with a median age of 65 (58.72) years, 70.3% exhibited inadequate adherence, with forgetfulness being the most common reason (55.4%). Patients receiving combined therapy with coronary revascularization showed higher adherence compared to those on optimal medical therapy alone. Low educational level (OR 1.68, IC 95% 1.23-2.23, p = 0.0001) and the use of optimal medical therapy alone (OR 1.2, I 95% 1.11-2.007 p = 0.007) were identified as predictors of poor adherence.

Conclusion: Among patients with ischemic heart disease and pharmacological therapy for secondary prevention, inadequate adherence is observed in 70% of cases. Factors associated with poor pharmacological adherence were low educational level and prescription of medical therapy without revascularization.

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缺血性心脏病患者坚持二级预防治疗的障碍：墨西哥参考中心的横断面研究。

目的本文旨在评估墨西哥城一家三甲医院心血管预防二线治疗的依从性水平，并确定充分依从药物治疗的主要障碍：2018年8月至2020年2月期间进行了一项单中心前瞻性横断面研究。研究收集了社会人口学数据，并采用了莫里斯基药物依从性量表。还在就诊期间进行了直接访谈，以确定不依从的原因：结果显示，在中位年龄为 65（58.72）岁的 991 名患者中，70.3% 的患者表现出用药依从性不足，其中最常见的原因是健忘（55.4%）。与单独接受最佳药物治疗的患者相比，接受冠状动脉血运重建联合治疗的患者依从性更高。低教育水平（OR 1.68，IC 95% 1.23-2.23，P = 0.0001）和单独使用最佳药物治疗（OR 1.2，I 95% 1.11-2.007，P = 0.007）被认为是依从性差的预测因素：结论：在接受药物治疗进行二级预防的缺血性心脏病患者中，70%的病例都存在依从性不足的问题。结论：在接受药物治疗进行二级预防的缺血性心脏病患者中，70%的病例都存在依从性不足的问题，与依从性不足有关的因素包括受教育程度低和处方中未包含血管重建治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Archivos de cardiologia de Mexico

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