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Assessment of Medication Adherence and Its Demographic and Clinical Determinants After Coronary Artery Bypass
Kyriakos Alexandrou1, Nicos Middleton1, Maria Kyranou1
1Department of Nursing, Cyprus University of Technology, Limassol, CYP.
Insights
Medication adherence improved significantly in cardiac surgery patients six months post-operation. Male patients and those with diabetes showed higher adherence, suggesting surgery may motivate better medication compliance.
Area of Science:
- Cardiology
- Pharmacology
- Health Services Research
Background:
- Medication adherence is crucial for postoperative recovery in cardiac surgery patients.
- Nonadherence can negatively impact recovery and long-term health outcomes.
- Understanding adherence patterns and influencing factors is vital for improving patient care.
Purpose of the Study:
- To measure medication adherence at 3 and 6 months post-coronary artery bypass grafting (CABG).
- To investigate the association between adherence and demographic/clinical factors in CABG patients in Cyprus.
Main Methods:
- Prospective, multicenter study of 97 adult CABG patients in Cyprus.
- Medication adherence assessed using the Adherence to Refills and Medications Scale (ARMS) via telephone interviews at 3 and 6 months.
- Statistical analysis included non-parametric tests to examine adherence trends and influencing factors.
Main Results:
- Medication adherence significantly improved from 3 to 6 months post-CABG (ARMS score decreased, p=0.012).
- High adherence rates increased from 37.1% to 50.5% over the study period.
- Male gender and diabetes mellitus were associated with higher adherence at 6 months (p=0.043 and p=0.025, respectively).
Conclusions:
- Significant improvement in medication adherence observed in the first six months after CABG.
- Surgery itself may act as a motivational factor for improved adherence.
- Long-term, patient-centered strategies are needed to ensure sustained medication adherence in this population.
Abstract:
Introduction Medication adherence is a critical component of postoperative care in cardiac surgery patients. Nonadherence may compromise recovery and long-term outcomes. This study aimed to measure medication adherence at three and six months postoperatively and examine its association with demographic and clinical factors among patients undergoing coronary artery bypass grafting (CABG) in Cyprus. Materials and methods This prospective multicenter study was conducted in two private hospitals and one public hospital in Cyprus between September 2022 and April 2023. A total of 97 adult patients who underwent elective CABG and completed follow-up assessments were included in the final analysis. Medication adherence was evaluated at three and six months postoperatively via structured telephone interviews using the Adherence to Refills and Medications Scale (ARMS). Demographic and clinical data were collected from medical records and preoperative interviews. Non-parametric tests (Wilcoxon, Mann-Whitney U, Kruskal-Wallis) were applied to examine adherence over time and its associations with demographic and clinical factors. Results The ARMS score significantly decreased from 13.24 (±1.34) at three months to 12.85 (±1.16) at six months (median: 13.00 to 12.00; p=0.012), indicating improved medication adherence over time. The proportion of patients with high adherence increased from 37.1% at three months to 50.5% at six months. Analysis of demographic and clinical factors showed that male gender (p=0.043) and the presence of diabetes mellitus (p=0.025) were significantly associated with higher adherence levels at six months. Discussion This study demonstrated a significant improvement in medication adherence over the first six months following CABG, particularly among male patients and those with diabetes mellitus. The improvement occurred in the absence of structured interventions, suggesting that surgery may serve as a motivational trigger for behavioral change. However, the persistence of moderate adherence highlights the need for long-term, patient-centered strategies to support sustained medication adherence in this population.
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