Abstract
Background: Percutaneous coronary intervention (PCI) is an effective treatment modality of coronary revascularization. Since this is not curative, medication adherence with a better patient satisfaction have a major impact on final clinical outcome. This study aims to assess medication adherence and patient satisfaction following PCI. Method: Total of 145 patients who underwent elective PCI during 2014 and 2015 at Cardiology Unit, Teaching Hospital Kandy, Sri Lanka were followed up. Medication adherence was assessed using Morisky Medication Adherence Scale (MMAS-8). Patient satisfaction was assessed using Patient Satisfaction Questionnaire. Results: Participants’ mean age was 54.97± 8.43 years and 80% (n=116) were males. Mean duration from last myocardial infarction to PCI was 0.89±1.84 years. Number of drugs consumed by a person per day was 7.77±2.33. Majority were on Aspirin (98.6%), Clopidogrel (99.3%) and statins (97.9%). According to MMAS-8, 90% (n=131) were mode-rate to high adherent to treatments. Forgetfulness (44.8%) and inaccessibility of drugs (13.9%) were the commonest reasons for low adherence. Low adherent to dual antiplatelet therapy was 8.3% (n=12). Majority were unaware about duration of Aspirin (78.6%, n=114) and Clopidogrel (85.5%, n=124) therapy. Major or minor bleeding was observed in 9% (n=13) as an adverse effect. There was no significant association of drug non-adherence with adverse effects of drugs (χ2=0.457, p=0.557). Overall satisfaction regarding health care was 95.9% (n=139). Satisfaction about accessibility and convenience of health system was the lowest (46.9%, n=68) with a positive association with male gender (χ2=3.662, p=0.043) and higher education level (χ2=14.741, p Conclusion: Majority of patients who underwent PCI had moderate to high adherence to pharmacological therapy. Even with limited resources, health system was able to provide a better PCI facility with high patient’s satisfaction in most number of aspects.
Highlights
Cardiovascular diseases remain the leading cause of death worldwide, contributing to 31 % of all global deaths[1] and ischemic heart disease (IHD) has a major contribution on this
Majority of patients who underwent Percutaneous coronary intervention (PCI) had moderate to high adherence to pharmacological therapy
Alcohol consumption is continued by 15.2% and 26.2% had stopped it after PCI
Summary
Cardiovascular diseases remain the leading cause of death worldwide, contributing to 31 % of all global deaths[1] and ischemic heart disease (IHD) has a major contribution on this. Due to limited facilities ACS is managed medically in most of the medical centers in Sri Lanka while elective PCI is performed at specialized centers. Since this intervention is not curative, it has to be accompanied by long term pharmacological and non-pharmacological therapeutic measures to control further progression of ACS. Medication adherence has a major impact on patient's health status. Percutaneous coronary intervention (PCI) is an effective treatment modality of coronary revascularization. Since this is not curative, medication adherence with a better patient satisfaction have a major impact on final clinical outcome. This study aims to assess medication adherence and patient satisfaction following PCI
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