Ambulatory assessment of medication adherence in high cardiovascular-risk patients. The Polish population of the EUROASPIRE V survey

Abstract

Introduction: Patients’ non-compliance with therapeutic recommendations is an important factor limiting the effectiveness of the treatment. This study aimed to compare patients’ declarations regarding their drug intake (Medication Adherence Questionnaire) with the results of the Adherence in Chronic Disease Scale (ACDS). Material and methods: The study included 200 patients (66.5% women) without prior cardiovascular events, diagnosed with hypertension, hypercholesterolemia, or diabetes within 6-24 months before the inclusion. To assess the therapeutic plan implementation the ACDS and the MAQ questionnaires were used. Results: Based on patients’ declarations, a satisfactory level of adherence (MAQ 5 and MAQ 4) was reported for 75.58% of patients treated for hypertension, 51.62% for diabetes, and 62.22% for hypercholesterolemia. A non-adherence risk assessment with the use of the ACDS yielded high results (i.e. low risk of non-adherence) in 38.58% of hypertension patients, 51.61% of diabetes patients 41.11% of hypercholesterolemia patients. Regardless of the disease, the patients indicating full (MAQ 5) or almost full (MAQ 4) therapeutic plan implementation often did not confirm that in similar question 1 of the ACDS. Conclusions: Patients’ self-assessment of the implementation of a therapeutic plan poses a risk of overestimation; particularly when it is based on answering only a single question. Additional application of the ACDS seems to help assess the risk of non-adherence as well as define barriers, beliefs, and behaviors that determine it. This assessment provides the basis to take action to improve the therapeutic plan implementation.