Predictors of Medication Adherence of Patients With Coronary Heart Disease After Percutaneous Coronary Intervention

Abstract

Background: The theory of planned behavior (TPB), combined with social support, forms the extended TPB, which has shown to predict adherence to health-related behavior effectively, but few studies have applied it to explain medication adherence in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). Objectives:The aim of this study was to explore the factors associated with medication adherence and the underlying mechanisms based on the extended TPB among patients with CHD after PCI. Methods: A cross-sectional descriptive study was conducted among patients with CHD after PCI in 2 major hospitals in Guangzhou, China. Medication adherence was measured with the Medication Adherence Report Scale. Constructs of the TPB contributing to medication adherence were assessed by the Theory of Planned Behavior Questionnaire for Medication Adherence. Social support was measured by the Multidimensional Scale of Perceived Social Support. Structural equation modeling was used to examine the hypotheses based on the extended TPB. Results: A total of 300 patients were surveyed and 26.0% of them were nonadherent. The structural equation modeling had good fit indices and estimated 62.6% of the variance in medication adherence. Regarding the relationships between the extended TPB constructs and medication adherence, "intention" was directly associated with medication adherence, and "perceived behavioral control" positively predicted medication adherence directly and indirectly. "Affective attitude" and "subjective norm" were indirectly associated with medication adherence through "intention." Social support exerted an indirect effect on medication adherence through "subjective norm." Conclusions: The extended TPB is an appropriate model to predict medication adherence and provides an effective framework for adherence-enhancing interventions.

Levels of adherence to treatment, illness perception and acceptance of illness in patients with coronary artery disease - descriptive and correlational study

“…The study’s findings revealed that a majority of participants (61.8%) adhered to their prescribed medication, aligning with prior research outcomes [ 34 – 36 ]. However, adherence rates display substantial variability across studies.…”

Application Analysis of Positive-Pressure Connector in Invasive Blood Pressure Monitoring in Coronary Interventional Therapy

“…Invasive blood pressure monitoring in coronary interventional therapy can accurately obtain patients' arterial blood pressure and timely observe patients' condition changes based on the changes of patients' blood pressure waveform, which is convenient for early detection of possible problems in treatment and timely formulation of treatment countermeasures ( 11 , 12 ). Invasive blood pressure monitoring refers to inserting a puncture needle directly into the artery, which is not affected by the measurement technique compared with non-invasive blood pressure.…”

“…However, invasive blood pressure monitoring requires the insertion of the puncture needle into the artery and retention for a period of time, which is highly likely to lead to complications such as wound infection at the puncture site of the patient, aggravating the treatment workload. At the same time, thrombosis is easy to form in the catheter, which may form embolism when entering the artery of the patient, affecting the patient's health ( 12 ). The positive-pressure connector is a kind of connector that can be kept absolutely sealed, and the connectionless state can guarantee the absolute sterility.…”

The Intention of Inhaled Medication Adherence Scale (IMAS): The Development of a New Instrument for Assessing Inhaled Medication Adherence Among Patients with Chronic Obstructive Pulmonary Disease (COPD) Using Theory of Planned Behavior

“…According to the guidelines of the TPB developer (ie, Prof. Icek Ajzen) 20,23 and previous studies using the TPB to design scales, [13][14][15][16][17][18] the first author (an experienced respiratory therapist) worked with the last author (an expert with extensive experience in TPB research) and created 25 initial items (13 for attitude; four for subjective norm; six for perceived behavioral control; and two for intention). Then, the 25 items together with the TPB definitions were sent to eight experts (in the fields of nursing, public health, behavioral sciences, and respiratory medicine) to evaluate.…”

“…Among the best theories in explaining human health behaviors is the Theory of Planned Behavior (TPB) which is one of the most used theories with wide applications across different health behaviors, including medication adherence. [13][14][15][16][17][18][19] However, to the best of the present authors' knowledge, no previous studies have used the TPB to better understand inhaled medication adherence among patients with COPD. Therefore, the present study used the TPB as the theoretical framework to develop a psychometric scale assessing psychological factors explaining inhaled medication adherence among this population.…”