Theory of the Action and Coping Plans for Medication Adherence Intervention Nursing Intervention to Promote Medication Adherence in Patients After Myocardial Infarction.

Background: Cardioprotective medications have been shown to be effective in reducing morbidity and mortality in patients with a history of myocardial infarction; however, the adherence rate is lower than expected. An adherence-based intervention was designed. Purpose: The purpose of the study is to describe the theory of "Action and Coping Plans for Medication Adherence Intervention (ADHERE)," a nursing intervention to promote adherence to cardioprotective medications. Methods: Theoretical and empirical approaches were combined with the clinical and research experience of a committee of experts to carry out the following stages: (a) in-depth understanding of the problem under study, (b) defining the objectives and identifying the theoretical framework of the intervention, and (c) operationalization of the intervention and identification of immediate, intermediate, and final outcomes. Results: The application of the stages resulted in the generation of the theory underpinning the ADHERE nursing intervention, which aims to promote adherence to cardioprotective medications in patients with a history of myocardial infarction and should be implemented by a nurse in a primary health care unit. The content of ADHERE is delivered through action and coping plans, developed by patients with the support of the nurse, verbally and in writing, in a meeting lasting 30 minutes and a reinforcement at a 30-day interval. Implications for Practice: The description of the theory of this intervention provides detailed information to researchers and health professionals about how the intervention contributes to changing behavior related to medication adherence and in what context; the theory can enhance the fidelity of its implementation in clinical practice.