Determinants of medication adherence in patients with acute coronary syndrome: a secondary analysis of a randomised clinical trial
Abstract
Background Coronary heart disease (CHD) remains a leading cause of mortality and disability worldwide. Approximately half of the patients who have had a prior hospital admission for CHD will have a recurrent coronary event, with the majority of these occurring within 12 months. Despite well-established evidence-based therapies, medication non-adherence is highly prevalent and reasons for medication non-adherence are poorly understood. This study evaluates factors influencing adherence to secondary prevention medications in people with acute coronary syndrome (ACS). Methods We performed a secondary analysis of TEXT messages to improve MEDication adherence and Secondary prevention after ACS (TEXTMEDS), a single-blind randomised clinical trial of 1424 patients with ACS from 18 hospitals across Australia. The primary outcome was self-reported medication adherence to each of up to five classes of guideline-recommended cardioprotective medications indicated for secondary prevention after ACS. Patients were followed up at 6-month and 12-month time points and were defined as adherent if at both time points, the proportion of indicated medications taken was >80% (>24/30 days in the preceding 1 month) for all five classes if not otherwise contraindicated. Logistic regression analysis and the Least Absolute Shrinkage and Selection Operator regularisation technique were used to assess the effect of sociodemographic and clinical factors on medication adherence. Results The analyses…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 1,424 participants or records.
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