Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Pulau Pinang, Malaysia.
Int J Clin Pharm. 2013 Apr;35(2):275-80. doi: 10.1007/s11096-012-9735-y. Epub 2013 Jan 3.
Secondary prevention pharmacotherapy improves outcomes after acute coronary syndrome (ACS). However, poor medication adherence is common, and various factors play a role in adherence.
The purpose of this study was to evaluate patients' level of adherence to evidence-based therapies at an average of 6 months after discharge for acs and to identify factors associated with self-reported non-adherence.
This prospective study was conducted in the outpatient cardiac clinics of Hospital Pulau Pinang, located in Penang Island, a northern state in Malaysia.
A random sample of ACS patients (n = 190) who had been discharged on a regimen of secondary preventive medications were included in this study. Six months after discharge and during their scheduled follow-up appointments to cardiac clinics, patients were interviewed using the translated eight-item Morisky Medication Adherence Scale.
self-reported patients' adherence to medication.
Six months following their hospital discharge, only 35 patients (18.4 %) reported high adherence. Medium adherence was reported in majority of patients (51.1 %). Low adherence was reported in 58 patients (30.5 %). Forgetfulness was the most frequently reported reason for patients' non-adherence to their medications (23.2 %). Furthermore, this study identified 5 factors-namely age, employment status, ACS subtypes, number of comorbidities, and number of prescription medications per day-that may influence Patients' level of adherence to the prescribed regimens.
Our findings revealed a problem of non-adherence to secondary prevention medications among patients with ACS in Malaysia. Furthermore, this study demonstrates that older patients, unemployed patients, patients with more comorbid conditions, and those receiving multiple medications are less likely to adhere to their prescribed medications 6 months after hospital discharge.
急性冠脉综合征（ACS）后，二级预防药物治疗可改善预后。然而，药物依从性差较为常见，多种因素会影响药物依从性。
本研究旨在评估 ACS 患者出院后平均 6 个月时的抗栓治疗依从性，并确定与自述不依从相关的因素。
本前瞻性研究在马来西亚北部槟城州的槟城医院的门诊心脏诊所进行。
纳入了接受二级预防药物治疗出院的 ACS 患者（n=190）的随机样本。在出院后 6 个月且在预约心脏诊所就诊期间，使用翻译后的 Morisky 药物依从量表对患者进行访谈，以评估其自我报告的药物依从性。
患者自述的药物依从性。
出院后 6 个月时，仅 35 例患者（18.4%）报告依从性高。多数患者（51.1%）报告中依从性。58 例患者（30.5%）报告低依从性。忘记服药是患者不遵医嘱的最常见原因（23.2%）。此外，本研究确定了 5 个可能影响患者对处方方案依从性的因素，即年龄、就业状况、ACS 亚型、合并症数量和每天服用的处方药数量。
我们的研究结果显示，马来西亚 ACS 患者存在二级预防药物治疗依从性问题。此外，本研究表明，年龄较大、失业、合并症较多以及服用多种药物的患者在出院后 6 个月时不太可能遵医嘱服药。
