Association Between Medication Adherence and Symptom Control in Patients With Chronic Stable Angina

Chronic stable angina is a frequent manifestation of ischemic heart disease and is associated with significant morbidity and impaired quality of life. Although evidence-based pharmacological therapy is effective in controlling anginal symptoms, its real-world benefit is highly dependent on patient medication adherence. Poor adherence may lead to persistent symptoms, increased healthcare utilization, and adverse clinical outcomes. However, data evaluating the relationship between medication adherence and symptom control in patients with chronic stable angina remain limited.

To evaluate the association between medication adherence and symptom control among patients with chronic stable angina in a tertiary care setting.

This retrospective observational study was conducted at Northwest General Hospital and Research Centre, Peshawar, from January 1 to December 31, 2023. Medical records of 200 adult patients diagnosed with chronic stable angina were reviewed. Medication adherence was assessed using prescription refill records and clinician documentation, with adherence defined as taking ≥80% of prescribed medications. Symptom control was evaluated using the Canadian Cardiovascular Society (CCS) angina classification documented during follow-up visits. The association between medication adherence and symptom control was analyzed using the chi-square test, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.

Of the 200 patients, 120 (60.0%) were classified as medication-adherent and 80 (40.0%) as non-adherent. Good symptom control was observed in 92 adherent patients (76.7%) compared with 38 non-adherent patients (47.5%). Poor symptom control was more frequent among non-adherent patients (52.5%). Medication adherence was significantly associated with better symptom control (χ² = 16.69, p < 0.001). Adherent patients had significantly higher odds of achieving good symptom control than non-adherent patients (OR = 3.63; 95% CI: 1.97-6.68).

Medication adherence is strongly associated with improved symptom control in patients with chronic stable angina. Routine assessment of adherence and targeted interventions to enhance compliance should be integrated into clinical practice to optimize symptom relief and improve patient outcomes.