Show simple item record

dc.contributor.authorKhatib, R.
dc.contributor.authorMarshall, K.
dc.contributor.authorSilcock, Jonathan
dc.contributor.authorForrest, C.
dc.contributor.authorHall, A.S.
dc.date.accessioned2019-07-04T12:54:57Z
dc.date.accessioned2019-07-04T14:03:39Z
dc.date.available2019-07-04T12:54:57Z
dc.date.available2019-07-04T14:03:39Z
dc.date.issued2019-07
dc.identifier.citationKhatib R, Marshall K, Silcock J et al (2019) Adherence to coronary artery disease secondary medicines: exploring modifiable barriers. Open Heart. 6(2): e000997.en_US
dc.identifier.urihttp://hdl.handle.net/10454/17162
dc.descriptionYesen_US
dc.description.abstractBackground: Non-adherence to secondary prevention medicines (SPMs) among patients with coronary artery disease (CAD) remains a challenge in clinical practice. This study attempted to identify actual and potential modifiable barriers to adherence that can be addressed in cardiology clinical practice. Methods: This was a cross-sectional, postal survey-based study of the medicines-taking experience of patients with CAD treated at a secondary/tertiary care centre. All participants had been on SPM for ≥3 months. Results: In total, 696 eligible patients were sent the survey and 503 responded (72.3%). The median age was 70 years, and 403 (80.1%) were male; the median number of individual daily doses of all medicines was 6. The rate of non-adherence to at least one SPM was 43.5% (n=219), but 53.3% of reported non-adherence was to only one SPM. Statins contributed to 66.7% and aspirin to 61.7% of overall non-adherence identified by the Single Question (SQ) tool. In 30.8% of non-adherent patients (n=65), this was at least partly intentional. Barriers included forgetfulness (84.9%; n=186), worry that medicines will do more harm than good (33.8%; n=74), feeling hassled about medicines taking (18.7%; n=41), feeling worse when taking medicines (14.2%; n=31) and not being convinced of the benefit of medicines (9.1%; n=20). In a multivariate analysis, modifiable factors associated with overall non-adherence included being prescribed aspirin (OR: 2.22; 95% CI: 1.18 to 4.17), having specific concern about SPM (OR: 1.12; 95% CI: 1.07 to 1.18) and issues with repeat prescriptions (OR: 2.48; 95% CI: 1.26 to 4.90). Different factors were often associated with intentional versus unintentional non-adherence. Conclusions: Using appropriate self-report tools, patients share actual and potential modifiable barriers to adherence that can be addressed in clinical practice. Non-adherence behaviour was selective. Most non-adherence was driven by forgetfulness, concern about the harm caused by SPM and practical barriers.en_US
dc.description.sponsorshipThe study was partially funded by the Leeds Teaching Hospitals Charitable Foundation.en_US
dc.language.isoenen_US
dc.rights© Author(s) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.en_US
dc.subjectAdherenceen_US
dc.subjectCoronary artery diseaseen_US
dc.subjectSecondary prevention medicinesen_US
dc.subjectModifiable barriersen_US
dc.subjectClinical practiceen_US
dc.titleAdherence to coronary artery disease secondary prevention medicines: exploring modifiable barriersen_US
dc.status.refereedYesen_US
dc.date.Accepted2019-06-13
dc.date.application2019-07-03
dc.typeArticleen_US
dc.type.versionPublished versionen_US
dc.identifier.doihttps://doi.org/10.1136/openhrt-2018-000997
dc.date.updated2019-07-04T11:55:03Z
refterms.dateFOA2019-07-04T14:04:44Z


Item file(s)

Thumbnail
Name:
e000997.full.pdf
Size:
486.3Kb
Format:
PDF
Description:
Silcock_Open_Heart_Final

This item appears in the following Collection(s)

Show simple item record