Community health worker-based intervention for adherence to drugs and lifestyle change after acute coronary syndrome: a multicentre, open, randomised controlled trial

Recent Approaches to Improve Medication Adherence in Patients with Coronary Heart Disease: Progress Towards a Learning Healthcare System

“…The foundation for this strategy was built on multiple studies of similar programs among infectious disease and post-partum patients, both in the USA and abroad [45]. Following these advances, a novel study of Indian patients published in 2016 demonstrated that post-ACS patients randomly assigned to receive educational visits from a community health worker were significantly more likely to adhere to their cardiac medication regimen (97 vs. 92%, p = 0.006) and were also more likely to quit smoking (85 vs. 52%, p < 0.001) and exercise (89 vs. 60%, p < 0.001) [46•]. Future studies might seek to validate this finding in other healthcare settings.…”

Improving medication adherence in patients with cardiovascular disease: a systematic review

“…Two of every three (65%) participants in the intervention group who received SMS reminders had a high adherence level compared with approximately one of every seven (13%) participants in the usual care group. SPREAD 2016 demonstrated improved adherence among the community health worker-based intervention group compared with usual care (97% in the intervention group compared with 92% in the control group; OR=2.62, 95% CI 1.32 to 5.19) as well as lower mean (SD) systolic blood pressure (124.4 (13.5) mm Hg versus 128.0 (15.9) mm Hg; P=0.002) and body mass index (24.4 (3.7) kg/m 2 versus 25.0 (3.8) kg/m 2 , P<0.0001) in the intervention group 23. In the UMPIRE trial, the fixed-dose combination group had improved adherence versus usual care (86% vs 65%; risk ratio of being adherent, 1.33; 95% CI 1.26 to 1.41; P<0.001) with concurrent reductions in SBP (−2.6 mm Hg; 95% CI −4.0 to –1.1 mm Hg) and LDL-C (−4.2 mg/dL; 95% CI −6.6 to –1.9 mg/dL) 26.…”

Association of Coronary Protective Factors Among Patients With Acute Coronary Syndromes

“…We observed an inverse association of fruit, vegetable, legume and nuts intake which is similar to other studies [2,7,25] . Apart from these foods, lower intake of sugars and saturated fat, trans fat and omega-6 fat have also been reported to be protective, and excess of these agents hazardous in patients with CVDs, obesity and diabetes [8][9][10][11][12][13][14] . Randomized, controlled trials have demonstrated the beneficial effects of fruits, vegetables, legumes and nuts in patients with ACS [7,[35][36][37] .…”

“…Unhealthy behaviors are responsible for secondary risk factors; obesity, hypertension, hypercholesterolemia, type 2 diabetes as well as metabolic syndrome characterized with dyslipidemia [6][7][8][9][10][11][12][13] . These secondary risk factors of CAD, may predispose ACS due to acute precipitating triggers; unhealthy behaviors; large meals, acute psychological stress, alcoholism, low and high temperature climates and acute exercise [6,[13][14][15] . However, CPF providing healthy behavior may prevent CVDs and diabetes.…”

“…There are only very few studies examining the role of protective health behavior in patients presenting with CAD and ACS [2,3] . Study of health behavior may be important because intervention strategy in patients with ACS improves adherence to evidence-based drugs and healthy lifestyles, and results in an improvement in clinical risk markers [14] . Association of coronary risk factors among these patients have been reported in a earlier publication [15] .…”