Relationships among medication adherence, lifestyle modification, and health-related quality of life in patients with acute myocardial infarction: a cross-sectional study

Abstract

BackgroundThe healthy adherer effect is a phenomenon in which patients who adhere to medical therapies tend to pursue health-seeking behaviors. Although the healthy adherer effect is supposed to affect health outcomes in patients with coronary artery disease, evaluation of its presence and extent is not easy. This study aimed to assess the relationship between medication adherence and lifestyle modifications and health-related quality of life among post-acute myocardial infarction (AMI) patients.MethodsA cross-sectional study was conducted in 417 post-AMI patients who underwent percutaneous coronary intervention (PCI). Patients were recruited from 11 university hospitals from December 2015 to March 2016 in South Korea. Details regarding socio-demographic factors, six health behaviors (low-salt intake, low-fat diet and/or weight-loss diet, regular exercise, stress reduction in daily life, drinking in moderation, and smoking cessation), medication adherence using the Modified Morisky Scale (MMS), and HRQoL using the Coronary Revascularization Outcome Questionnaire (CROQ) were surveyed in a one-on-one interview.ResultsIn the univariate logistic analysis, sex (female), age (≥70 years), MMS score (≥5), and CROQ score were associated with adherence to lifestyle modification. In the multiple logistic analysis, a high MMS score (≥5) was associated with adherence to lifestyle modification after adjusting for sex, age, marital status, education, and family income (adjusted odds ratio [OR] = 11.7, 95% confidence interval [CI] = 1.5–91.3). After further adjusting for the CROQ score, the association between high MMS score and adherence to lifestyle modification was significant (adjusted OR = 11.5, 95% CI = 1.4–93.3).ConclusionsAdherence to medication was associated with adherence to lifestyle modification, suggesting the possible presence of the healthy adherer effect in post-AMI patients. After further adjusting for HRQoL, the association remained. To improve health outcome in post-AMI patients, early detection of patients with poor adherence to medication and lifestyle modification and motivational education programs to improve adherence are important. In addition, the healthy adherer effect should be considered in clinical research, in particular, in studies evaluating the effects of therapies on health outcomes.Electronic supplementary materialThe online version of this article (10.1186/s12955-018-0921-z) contains supplementary material, which is available to authorized users.

Impact of readiness for discharge from the hospital on the implementation of the therapeutic plan

“…Non-adherence to medical recommendations, especially those concerning the use of drugs, is considered a significant problem in patients after myocardial infarction. The non-adherence to treatment is associated with increased incidence of adverse clinical events as well as treatment costs [6,[18][19][20][21][22][23]. According to the data presented by Naderi et al, adherence of patients diagnosed with coronary artery disease during two years of follow-up is only 50-66% [6].…”

Correlation between exercise, personal income level and health-related quality of life in patients with newly diagnosed stable angina

“…Angina is the initial clinical manifestation in 25 to 50% of all CAD patients [21, 22] and has been associated with poor HRQL and depressive symptoms; individuals with angina exhibit higher scores for pain or worry relative to those observed in individuals without angina [23–26]. Furthermore, reduced HRQL has been associated with poor prognosis in CAD patients [27, 28]. Therefore, exploration of risk factors affecting HRQL scores in patients with newly diagnosed stable angina is of great importance.…”

Coronavirus and Cardiometabolic Syndrome

“…The role of healthy lifestyles and pharmacotherapy targeting metabolic drivers to reduce cardiovascular risk is well established ( 1 , 2 ). However, lessons learned from the COVID-19 pandemic support shorter-term benefits of these interventions, similar to observed benefits on acute cardiovascular disease (CVD) outcomes ( 3 ). Therefore, a prevention program for patients of all ages should be developed to create a healthy culture, reduce chronic disease risks, and mitigate unforeseen acute insults, such as COVID-19.…”