Department of Internal Medicine, Institute of Health Sciences, College of Medicine, Gyeongsang National University Jinju 52727, Korea.
Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon 51472, Korea.
Int J Environ Res Public Health. 2020 May 20;17(10):3585. doi: 10.3390/ijerph17103585.
Non-adherence to medications can be classified as unintentional and intentional. The aim of this study was to establish the major determinants of each non-adherence in myocardial infarction (MI). We also evaluated the effects of non-adherences on healthy behaviors.
We enrolled 510 patients >1 year after MI. Nonadherences classified as unintentional or intentional were measured by a self-reported questionnaire. Polynomial and multiple regression analysis were performed to evaluate the determinant of each type of nonadherences.
Among patients with nonadherence, 263 (70.7%) patients were unintentionally non-adherent while 109 (29.3%) patients were intentionally non-adherent. Psychological belief and attitude were important in unintentional non-adherence (Exp(β) = 0.917, = 0.050 for anxiety; Exp(β) = 1.191, = 0.001 for concerns). Beliefs about medications were the strongest determinant of intentional non-adherence (Exp(β) = 0.812, < 0.001 for necessity; Exp(β) = 1.421, < 0.001 for concerns). Anxiety was important determinant of intentional non-adherence (Exp(β) = 0.889, = 0.015).
Psychological factors and beliefs about medication were important determinants of both types of non-adherence. Combined approaches targeting the beliefs about medications and psychological distress are needed to improve drug adherence in patients with MI.
药物不依从可分为无意和有意。本研究旨在确定心肌梗死（MI）中每种不依从的主要决定因素。我们还评估了不依从对健康行为的影响。
我们招募了 MI 后 >1 年的 510 名患者。通过自我报告问卷测量不依从性，分为无意和有意。进行多项式和多元回归分析，以评估每种不依从的决定因素。
在不依从的患者中，263 名（70.7%）患者为无意不依从，109 名（29.3%）患者为有意不依从。心理信念和态度在无意不依从中很重要（Exp（β）=0.917， =0.050 用于焦虑；Exp（β）=1.191， =0.001 用于担忧）。对药物的信念是有意不依从的最强决定因素（Exp（β）=0.812， <0.001 用于必要性；Exp（β）=1.421， <0.001 用于担忧）。焦虑是有意不依从的重要决定因素（Exp（β）=0.889， =0.015）。
心理因素和对药物的信念是两种不依从的重要决定因素。需要针对药物信念和心理困扰采取综合方法，以提高 MI 患者的药物依从性。
