Abstract
To assess the impact of beliefs towards illness and medications on adherence and readmission in acute coronary syndrome (ACS) patients A phone interview that evaluated beliefs towards illness using the Brief Illness Perception Questionnaire (BIPQ), beliefs towards medications using the Beliefs about Medicines Questionnaire (BMQ) and adherence using a self-reported scale was done. Patients discharged for 1, 6, and 12 months were recruited and surveyed. 1-month, 6-month and 12-month readmission data was collected. Spearman’s rank correlation was used to show correlation between belief scores, adherence and readmission, while ordinal regression was used to adjust for covariates. Seventy-nine patients were surveyed; 30, 22, and 27 were discharged from the index ACS admission for 1, 6 and 12 months respectively. Significant positive correlations were found between adherence score with BMQ-Specific Necessity score (rs=0.287, p=0.010), necessity-concerns differential (rs=0.539, p<0.001), and an inverse correlation between adherence and BMQ-Specific Concerns score (rs=-0.443, p<0.001). Higher BMQ Specific-Necessity scores (aOR=1.404, 95% CI:1.147-1.719) and a monthly income less than HKD$10,000 compared to HK$10,000 or greater (aOR=4.540, 95% CI: 1.761-14.311) was associated with higher adherence, while higher BMQ Specific-Concerns scores were related to lower adherence (aOR=0.774, 95% CI: 0.672-0.892). Total BIPQ score (OR=1.134, 95% CI: 1.005–1.278) and number of previous ACS episodes (OR=19.000, 95% CI: 2.029–177.932) predicted 6-month all-causereadmissions and 12-month cardiac readmissions respectively. Patients’ perceived necessity and concerns towards medications and an income less than HK$10,000 were significantly associated with adherence. Illness perceptions and history of ACS predicted readmissions. These findings are useful for developing interventions to improve adherence in ACS patients.
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