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Patterns of Adherence to Secondary Prevention Measures Among Chinese Patients With Coronary Artery Disease: A

Minmin Lu, Marilyn Hravnak, Yuefang Chang

    The Journal of Cardiovascular Nursing
    |July 9, 2021
    PubMed

    Insights

    Patient adherence to coronary artery disease (CAD) secondary prevention changes over time. Understanding these adherence trajectories and their predictors is key for improving patient outcomes.

    Area of Science:

    • Cardiology
    • Health Services Research
    • Behavioral Science

    Background:

    • Adherence to secondary prevention measures is crucial for patients with coronary artery disease (CAD).
    • Patient adherence behaviors are dynamic and can change significantly over time.
    • Understanding these changes is vital for improving patient prognosis and long-term outcomes.

    Purpose of the Study:

    • To identify distinct adherence trajectories for medication-taking and heart-healthy lifestyle among CAD patients.
    • To determine the predictors associated with these identified adherence trajectories.
    • To inform targeted interventions for enhancing secondary prevention adherence in CAD.

    Main Methods:

    • Longitudinal study of 698 patients with CAD post-percutaneous coronary intervention in China.
    • Group-based trajectory models were used to analyze adherence patterns over 1 year.
    • Multinomial logistic regression identified predictors including demographics, disease knowledge, self-efficacy, and health literacy.

    Main Results:

    • Four medication-taking adherence trajectories were identified: sustained adherence (39.9%), increasing-decreasing (23.1%), increasing (23.4%), and nonadherence (13.6%).
    • Three heart-healthy lifestyle adherence trajectories were found: sustained adherence (59.7%), increasing (28.3%), and nonadherence (12.0%).
    • Predictors varied, with marriage linked to sustained medication adherence, and higher health literacy to sustained lifestyle adherence. Lower disease knowledge and absence of coronary stents were associated with lower adherence.

    Conclusions:

    • Adherence to secondary prevention in Chinese CAD patients follows diverse patterns.
    • Healthcare providers should develop tailored support strategies.
    • Interventions must consider individual factors like disease knowledge, self-efficacy, and health literacy to improve adherence.
    Abstract

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