Orozco-Moreno José R, Berríos-Bárcenas Enrique A, Palacios-Gutiérrez Dante, Aldaco-Rodríguez Alfonso R, Ávila-Vanzzini Nydia, Cossío-Aranda Jorge E, Cel Valle-Chávez Claudia, Leyva-Balderas Mario, Maza-Larrea José A, Roldán-Gómez Francisco J
Clínica de Miocardiopatias, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México.
Departamento de Cardiología, Centro Médico Nacional de Occidente, Guadalajara. México.
Arch Cardiol Mex. 2024 Sep 3;95(1):26-33. doi: 10.24875/ACM.24000034.
This article aims to assess the adherence level to second-line therapy for cardiovascular prevention in a tertiary hospital in Mexico City and identify key barriers to adequate pharmacological adherence.
A single-center prospective cross-sectional study was conducted between August 2018 and February 2020. Sociodemographic data were collected, and the Morisky medication adherence scale was performed. Directed interviews during medical consultations were also conducted to determine reasons for non-adherence.
Showed that out of 991 patients included with a median age of 65 (58.72) years, 70.3% exhibited inadequate adherence, with forgetfulness being the most common reason (55.4%). Patients receiving combined therapy with coronary revascularization showed higher adherence compared to those on optimal medical therapy alone. Low educational level (OR 1.68, IC 95% 1.23-2.23, p = 0.0001) and the use of optimal medical therapy alone (OR 1.2, I 95% 1.11-2.007 p = 0.007) were identified as predictors of poor adherence.
Among patients with ischemic heart disease and pharmacological therapy for secondary prevention, inadequate adherence is observed in 70% of cases. Factors associated with poor pharmacological adherence were low educational level and prescription of medical therapy without revascularization.
本文旨在评估墨西哥城一家三级医院心血管疾病二级预防二线治疗的依从性水平，并确定药物依从性不足的关键障碍。
于2018年8月至2020年2月开展了一项单中心前瞻性横断面研究。收集了社会人口统计学数据，并采用了莫里isky药物依从性量表。在医疗咨询期间还进行了定向访谈，以确定不依从的原因。
结果显示，在纳入的991例患者中，中位年龄为65（58.72）岁，70.3%的患者依从性不足，遗忘是最常见的原因（55.4%）。与仅接受最佳药物治疗的患者相比，接受冠状动脉血运重建联合治疗的患者依从性更高。低教育水平（OR 1.68，95%置信区间1.23 - 2.23，p = 0.0001）和仅使用最佳药物治疗（OR 1.2，95%置信区间1.11 - 2.007，p = 0.007）被确定为依从性差的预测因素。
在缺血性心脏病和二级预防药物治疗的患者中，70%的病例存在依从性不足的情况。与药物依从性差相关的因素是低教育水平和未进行血运重建的药物治疗处方。
