Department of Biostatistics and Medical Informatics, Institute for Preventive Medicine and Public Health, Hanoi Medical University, 01 Ton That Tung Str, Dong Da Dist, Hanoi, Vietnam.
Vietnam National Heart Institute, 78 Giai Phong Str, Phuong Dinh Precinct, Dong Da Dist, Hanoi, Vietnam.
Biomed Res Int. 2019 Apr 24;2019:6585040. doi: 10.1155/2019/6585040. eCollection 2019.
Adherence to antiplatelet therapy is critical to successful treatment of cardiovascular conditions. However, little has been known about this issue in the context of constrained resources such as in Vietnam. The objective of this study was to examine the adherence to antiplatelet therapy among patients receiving acute myocardial infarction interventions and its associated factors. In a cross-sectional survey design, 175 adult patients revisiting Vietnam National Heart Institute diagnosed with acute myocardial infarction were approached for data collection from October 2014 to June 2015. Adherence to antiplatelet therapy was assessed by asking patients whether they took taking antiplatelet regularly as per medication (do not miss any dose at the specified time) for any type of antiplatelet (aspirin, clopidogrel, ticlopidine...) during the last month before the participants came back to take re-examinations. The results indicated that the adherence to antiplatelet therapy among patients was quite high at 1 month; it begins to decline by 6 months, 12 months, and more than 12 months (less than 1 month was 90.29%; from 1 to 6 months 88.0%, from 6 to 12 months 75.43%, and after 12 months only 46.29% of patients). Multivariable logistic regression was utilized to detect factors associated with the adherence to antiplatelet therapy. It showed that patients with average income per month of $300 or more (OR=2.92, 95% CI=1.24-6.89), distance to the hospital of less than 50km (OR=2.48, 95% CI: 1.12-5.52), taking medicine under doctor's instructions (OR=3.65; 95% CI=1.13-11.70), and timely re-examination (OR=3.99, 95% CI=1.08-14.73) were more likely to follow the therapy. In general, the study suggested that to increase the likelihood of adherence to antiplatelet therapy it is important to establish a continuous care system after discharging from hospital.
抗血小板治疗的依从性对心血管疾病的成功治疗至关重要。然而，在越南等资源有限的情况下，人们对这一问题知之甚少。本研究的目的是探讨急性心肌梗死介入治疗患者的抗血小板治疗依从性及其相关因素。采用横断面调查设计，于 2014 年 10 月至 2015 年 6 月期间，对越南国家心脏研究所复诊的 175 名成年急性心肌梗死患者进行数据收集。通过询问患者在最后一个月来复查之前是否按规定时间（不遗漏任何剂量）定期服用（不遗漏任何剂量）任何类型的抗血小板药物（阿司匹林、氯吡格雷、噻氯匹定……）来评估抗血小板治疗的依从性。结果表明，患者在 1 个月时的抗血小板治疗依从性相当高；6 个月、12 个月和 12 个月以上时，依从性开始下降（不足 1 个月为 90.29%；1-6 个月为 88.0%，6-12 个月为 75.43%，12 个月以上为 46.29%）。采用多变量逻辑回归检测与抗血小板治疗依从性相关的因素。结果显示，月收入在 300 美元或以上的患者（OR=2.92，95%CI=1.24-6.89）、距离医院小于 50 公里的患者（OR=2.48，95%CI：1.12-5.52）、遵医嘱服药的患者（OR=3.65；95%CI=1.13-11.70）和及时复查的患者（OR=3.99，95%CI=1.08-14.73）更有可能坚持治疗。总的来说，该研究表明，建立出院后的连续护理系统对于提高抗血小板治疗的依从性至关重要。
