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Factors Associated With Clopidogrel Adherence in Community-Dwelling Patients
Kathryn M Momary1, Laura P Kimble
1Kathryn M. Momary, PharmD, BCPS Associate Professor, College of Pharmacy, Department of Pharmacy Practice, Mercer University, Atlanta, Georgia. Laura P. Kimble, PhD, RN Professor, Piedmont Healthcare Endowed Chair in Nursing, Georgia Baptist College of Nursing of Mercer University, Atlanta, Georgia.
Insights
Patient perceptions of clopidogrel necessity and concerns, alongside nuisance bleeding severity, significantly predict adherence to clopidogrel therapy. Understanding these factors can improve cardiovascular medication management.
Area of Science:
- Cardiology
- Pharmacology
- Health Psychology
Background:
- Clopidogrel is a critical antiplatelet medication for cardiovascular patients.
- Adherence to clopidogrel therapy is essential for preventing thrombotic events.
- Predictors of adherence, particularly patient-reported factors, require further investigation.
Purpose of the Study:
- To identify key predictors of adherence to clopidogrel therapy.
- To explore the influence of patients' perceptions of clopidogrel and nuisance bleeding on adherence.
Main Methods:
- Cross-sectional study involving 102 community-dwelling cardiovascular patients prescribed clopidogrel.
- Assessment of depressive symptoms, social support, nuisance bleeding, and clopidogrel perceptions via self-report questionnaires.
- Analysis using the Morisky Medication Adherence Scale and hierarchical multiple linear regression.
Main Results:
- 55% of patients exhibited low adherence, 28% moderate, and 16% high adherence.
- Perceived necessity of clopidogrel was positively associated with adherence.
- Lower perceived concerns about clopidogrel and greater severity of nuisance bleeding predicted better adherence.
Conclusions:
- Patient beliefs regarding clopidogrel's necessity and concerns are significant determinants of adherence.
- Nuisance bleeding severity also plays a role in medication adherence.
- Interventions targeting patient perceptions may enhance clopidogrel therapy adherence.
Objective:
The purpose of this study was to characterize predictors of adherence to clopidogrel therapy focusing on patients' perceptions of clopidogrel and nuisance bleeding.
Methods:
This was a cross-sectional study of community-dwelling cardiovascular patients with a self-reported prescription for clopidogrel. Self-report questionnaires assessed depressive symptoms, social support, nuisance bleeding, perceptions of clopidogrel, and adherence to therapy. Low, moderate, and high adherence groups based on the Morisky Medication Adherence Scale were compared and hierarchical multiple linear regression analysis was used to predict adherence.
Results:
A total of 102 subjects were enrolled, and 55%, 28%, and 16% were classified as having low, moderate, and high adherence, respectively. Greater perceptions of clopidogrel necessity, lower perception of clopidogrel concern, and increased severity of nuisance bleeding were predictors of better adherence.
Conclusions:
Data from this cross-sectional study suggest that concerns about clopidogrel and feelings about its necessity play an important role in clopidogrel adherence.
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