Predictors of adherence to treatment by patients with coronary heart disease after percutaneous coronary intervention

• Published in: Journal of clinical nursing 2018-03, Vol.27 (5-6), p.989-1003
• Main Authors: Kähkönen, Outi, Saaranen, Terhi, Kankkunen, Päivi, Lamidi, Marja‐Leena, Kyngäs, Helvi, Miettinen, Heikki
• Format: Article
• Language: English
• Subjects: adherence; Angioplasty; Cardiovascular disease; coronary heart disease; Disease management; Health behavior; Heart; Lifestyles; Low density lipoprotein; Nursing; Patient compliance; percutaneous coronary intervention; Personal relationships; Quantitative analysis
• ISSN: 0962-1067; 1365-2702
• DOI: 10.1111/jocn.14153

Aims and objectives To identify the predictors of adherence in patients with coronary heart disease after a percutaneous coronary intervention. Background Adherence is a key factor in preventing the progression of coronary heart disease. Design An analytical multihospital survey study. Methods A survey of 416 postpercutaneous coronary intervention patients was conducted in 2013, using the Adherence of People with Chronic Disease Instrument. The instrument consists of 37 items measuring adherence and 18 items comprising sociodemographic, health behavioural and disease‐specific factors. Adherence consisted of two mean sum variables: adherence to medication and a healthy lifestyle. Based on earlier studies, nine mean sum variables known to explain adherence were responsibility, cooperation, support from next of kin, sense of normality, motivation, results of care, support from nurses and physicians, and fear of complications. Frequencies and percentages were used to describe the data, cross‐tabulation to find statistically significant background variables and multivariate logistic regression to confirm standardised predictors of adherence. Results Patients reported good adherence. However, there was inconsistency between adherence to a healthy lifestyle and health behaviours. Gender, close personal relationship, length of education, physical activity, vegetable and alcohol consumption, LDL cholesterol and duration of coronary heart disease without previous percutaneous coronary intervention were predictors of adherence. Conclusions The predictive factors known to explain adherence to treatment were male gender, close personal relationship, longer education, lower LDL cholesterol and longer duration of coronary heart disease without previous percutaneous coronary intervention. Relevance to clinical practice Because a healthy lifestyle predicted factors known to explain adherence, these issues should be emphasised particularly for female patients not in a close personal relationship, with low education and a shorter coronary heart disease duration with previous coronary intervention.