Compliance to modification of risk factors for recurrent myocardial infarction in the long term of the disease: a randomized study
DOI:
https://doi.org/10.15391/prrht.2023-8(2).02Keywords:
myocardial infarction, risk factors, awareness, compliance, secondary preventionAbstract
Purpose: to study the relationship between awareness and commitment to modifying risk factors for recurrent myocardial infarction in a long period of the disease.
Material & Methods: to study the awareness of risk factors and adherence to secondary prevention of myocardial infarction (MI), a representative sample was created. Of 912 patients treated for myocardial infarction, 333 patients were randomized, taking into account proportional distribution in the population by age (under 65 and over 65 years) and gender. The average age of patients was 62.5±9.8 years: 70,27% of men and 29,73% of women.
Patients' awareness of risk factors, the use of preventive measures and adherence to treatment were assessed on the basis of a questionnaire.
Statistical processing of the obtained material was carried out using the statistical program STATISTICA 12.5 (StatSoft.Inc). Results are presented as mean and standard deviation (M±s), number of options (n). To compare the qualitative characteristics (frequency tables), the χ2 test and Fisher's exact test were used.
All participants were informed about the aims of the study and gave written consent to participate in the study.
Results: low awareness (Aw) and commitment (Cm) to the modification of such risk factors for recurrent infarction in a long period of the disease as: reduced fat intake Aw 16,52%, Cm 19,4%; regular consumption of vegetables and fruits Aw 11,41%, Cm 9,7%; smoking cessation Aw 15,92%, Cm 11,04%; decrease in alcohol consumption Aw 16,52%, Cm 10,70%; increased physical activity Aw 14,41%, Cm 12,37%; weight loss with its excess Aw 3,0%, Cm 2,34%; avoidance of stress Aw 28,53%, Cm 18,06%. Although the vast majority of patients received appropriate recommendations from the doctor.
Conclusions: low awareness of the possibility of modifying heart disease risk factors is associated with the failure to implement such non-pharmacological measures in secondary prevention after MI: decrease in fat intake (χ2=65,12; p=0,000) and regular consumption of vegetables and fruits (F p=0,000), unwillingness to quit smoking (F p=0,000) and decrease in alcohol consumption (F p=0,000), unwillingness to increase physical activity (χ2=17,61; p=0,000) and reduce weight in case of its excess (F p=0,015), avoiding stress (χ2=27,42; p=0,000).
References
Aggarwal, M., Ornish, D., Josephson, R., Brown, T.M., Ostfeld, R.J., Gordon, N., Madan S., Allen K., Khetan A., Mahmoud A., Freeman A.M., & Aspry K. (2021). Closing Gaps in Lifestyle Adherence for Secondary Prevention of Coronary Heart Disease. The American Journal of Cardiology, 145, 1-11. https://doi.org/10.1016/j.amjcard.2021.01.005
Anderson, L., Brown, J.P., Clark, A.M., Dalal, H., Rossau, H.K., Bridges, C., & Taylor, R.S. (2017). Patient education in the management of coronary heart disease. The Cochrane database of systematic reviews, 6(6), CD008895. https://doi.org/10.1002/14651858.CD008895.pub3
Anderson, L., Sharp, G.A., Norton, R.J., Dalal, H., Dean, S.G., Jolly, K., Cowie, A., Zawada, A., Taylor, R.S. (2017). Home‐based versus centre‐based cardiac rehabilitation. Cochrane Database of Systematic Reviews, 6, CD007130. https://doi.org/10.1002/14651858.CD007130.pub4
Cohen, A., Assyag, P., Boyer-Chatenet, L., Cohen-Solal, A., Perdrix, C., Dalichampt, M., Michel, P.-L., Montalescot, G., Ravaud, P., Steg, P.G., & Boutron, I. (2014). An education program for risk factor management after an acute coronary syndrome: a randomized clinical trial. JAMA internal medicine, 174(1), 40-48. https://doi.org/10.1001/jamainternmed.2013.11342
Hasandokht, T., Salari, A., Mirbolouk, F., Rajati, F., Ashouri, A. (2016). Medication adherence and quality of life in coronary artery bypass grafting patients, results of retrospective cohort study. Anatol J Cardio, 16, 895. https://doi.org/10.14744/AnatolJCardiol.2016.7398
Kämpfer, J., Yagensky, A., Zdrojewski, T., Windecker, S., Meier, B., Pavelko M., Sichkaruk, I., Kasprzyk, P., Gruchala, M., Giacomini, M., Räber, L., Saner, H. (2017). Long-term outcomes after acute myocardial infarction in countries with different socioeconomic environments: an international prospective cohort study. BMJ Open, 7, e012715. https://doi.org/10.1136/bmjopen-2016-012715
Kang, K., Gholizadeh, L., Inglis, S.C., Han, H.R. (2017). Correlates of health-related quality of life in patients with myocardial infarction: A literature review. Int J Nurs Stud, 73, 1-16. https://doi.org/10.1016/j.ijnurstu.2017.04.010
Mathews, R., Wang, T.Y., Honeycutt, E., Henry, T.D., & Zettler, M. (2015). Chang M.Persistence with secondary prevention medications after acute myocardial infarction: Insights from the TRANSLATE-ACS study. American heart journal, 170(1), 62-69. https://doi.org/10.1016/j.ahj.2015.03.019
O'Gara, P.T., Kushner, F.G., Ascheim, D.D., Casey, D.E. Jr., Chung, M.K., de Lemos, J.A., Ettinger, S.M., Fang, J.C, Fesmire, F.M., Franklin, B.A., Granger, C.B., Krumholz, H.M., Linderbaum, J.A., Morrow, D.A., Newby, L.K., Ornato, J.P., Ou, N., Radford, M.J., Tamis-Holland, J.E., Tommaso, C.L. et al. (2013). 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation, 127, 362-425. https://doi.org/10.1161/CIR.0b013e3182742cf6
Sedykh, D.Yu., Petrov, G.P., & Kashtalap, V.V. (2018). Differences in adherence behaviour patterns in patients with primary and recurrent myocardial infarction. Complex Issues of Cardiovascular Diseases., 7(4), 15-25. https://doi.org/10.17802/2306-1278-2018-7-4-15-25
Sichkaruk, I., Yagensky, A., Belikova, N., Dukhnevych, L., Indyka, S., Sitovskyi, A., & Sydor, N. (2008). Self-reported adherence to treatment and arterial hypertension control in patients after ischemic stroke and myocardial infarction. Journal Of Hypertension, 26, 398. PMID: 18795450
Tuna, S. & Çinar, S. (2021). The effectiveness of planned discharge education on health knowledge and beliefs in patients with acute myocardial infarction: a randomized controlled trial. Irish Journal of Medical Science, 191. https://doi.org/10.1007/s11845-021-02601-7
Uddin, J., Joshi, V.L., Moniruzzaman, M., Karim, R., Uddin, J., Siraj, M., Rashid, Mohammad Abdur, Rossau, H.K., Taylor, R.S.; Zwisler, A.-D., & Zwisler, A.D. (2020). Effect of Home-Based Cardiac Rehabilitation in a Lower-Middle Income Country: RESULTS FROM A CONTROLLED TRIAL. Journal of Cardiopulmonary Rehabilitation and Prevention, 40(1), 29-34. https://doi.org/10.1097/HCR.0000000000000471
Wienbergen, H., Fach, A., Meyer, S., Meyer, J., Stehmeier, J., Backhaus, T., & Hambrecht, R. (2019). Effects of an intensive long-term prevention programme after myocardial infarction – a randomized trial. European journal of preventive cardiology, 26(5), 522-530. https://doi.org/10.1177/2047487318781109
Yagensky, A. & Sichkaruk, I. (2019). Compliance with treatment of patients in the remote period after myocardial infarction. Rational pharmacotherapy, 1-2 (50-51), 24-27. bit.ly/3Pgb6RR
Yagenskyi, A.V., Sitovskyi, A.M., Belikova, N.O., & Indika S.J. (2023). Assessment of the quality of secondary prevention of cardiovascular disease: a questionnaire [Text]. https://evnuir.vnu.edu.ua/handle/123456789/22311
Yudi, M.B., Clark, D.J., Tsang, D., Jelinek, M., Kalten, K., Joshi, S., Phan, K., Ramchand, J., Nasis, A., Amerena, J., Koshy, A. N., Murphy, A.C., Arunothayaraj, S., Si, S., Reid, C., & Farouque, O. (2020). Smartphone-based, early cardiac rehabilitation in patients with acute coronary syndromes: a randomized controlled trial. Coronary artery disease, Advance online publication. https://doi.org/10.1097/MCA.0000000000000938
Yu-Mi Lee, Rock Bum Kim, Hey Jean Lee, Keonyeop Kim, Min-Ho Shin, Hyeung-Keun Park, Soon-Ki Ahn, So Young Kim, Young-Hoon Lee, Byoung-Gwon Kim, Heeyoung Lee, Won Kyung Lee, Kun Sei Lee, Mi-Ji Kim, & Ki-Soo Park (2018). Relationships among medication adherence, lifestyle modification, and health-related quality of life in patients with acute myocardial infarction: a cross-sectional study. Health and quality of life outcomes, 16(1), 1-8. https://doi.org/10.1186/s12955-018-0921-z
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Sitovskyi, A. et al.
This work is licensed under a Creative Commons Attribution 4.0 International License.