Medication noncompliance and patient satisfaction following percutaneous coronary intervention

This study evaluated the relationship between medication noncompliance and patient satisfaction in patients with drug-eluting stent revascularization in Armenia.

Reasons for medication noncompliance are multifactorial--often related to health system, patient, condition, therapy, and socioeconomic factors.

The analytical cross-sectional survey used a simple random sample of patients aged 18 and over who had undergone percutaneous coronary artery intervention with drug-eluting stent from 2006 to 2008 (n = 271) at Nork Marash Medical Center, Yerevan, Armenia. Medication noncompliance was assessed using the Morisky Adherence Scale. Patient satisfaction items were selected from the Patient Satisfaction Questionnaire (PSQ-18).

Respondents' mean age was 57.5 ± 9.8 years. Most (87.8%) were male. Nearly one-third of patients (31.0%) were noncompliant. Most reported good health (91.9%). Respondents most often cited out-of-pocket costs as a reason for noncompliance (19.2%). Age, gender, health status, smoking status, and cost were associated with medication noncompliance (P < 0.05). Noncompliance was not associated with elapsed time after the intervention or satisfaction (P > 0.05). Medication noncompliance was positively related to cost (odds ratio [OR]= 2.57, 95% CI = 1.33-4.97) and inversely related to health status (OR = 0.46, 95% CI = 0.25-0.85) and age (OR = 0.94, 95% CI = 0.91-0.97).

Medication noncompliance is a multifactorial problem. Strategies reducing the economic burden on patients should improve compliance and, thus, treatment outcomes. These findings further efforts to benchmark performance in Armenia and other post-Soviet countries against western standards and experiences.