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Predictors of adherence to treatment by patients with coronary heart disease after percutaneous coronary intervention

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Listed:
  • Outi Kähkönen
  • Terhi Saaranen
  • Päivi Kankkunen
  • Marja‐Leena Lamidi
  • Helvi Kyngäs
  • Heikki Miettinen

Abstract

Aims and objectives To identify the predictors of adherence in patients with coronary heart disease after a percutaneous coronary intervention. Background Adherence is a key factor in preventing the progression of coronary heart disease. Design An analytical multihospital survey study. Methods A survey of 416 postpercutaneous coronary intervention patients was conducted in 2013, using the Adherence of People with Chronic Disease Instrument. The instrument consists of 37 items measuring adherence and 18 items comprising sociodemographic, health behavioural and disease‐specific factors. Adherence consisted of two mean sum variables: adherence to medication and a healthy lifestyle. Based on earlier studies, nine mean sum variables known to explain adherence were responsibility, cooperation, support from next of kin, sense of normality, motivation, results of care, support from nurses and physicians, and fear of complications. Frequencies and percentages were used to describe the data, cross‐tabulation to find statistically significant background variables and multivariate logistic regression to confirm standardised predictors of adherence. Results Patients reported good adherence. However, there was inconsistency between adherence to a healthy lifestyle and health behaviours. Gender, close personal relationship, length of education, physical activity, vegetable and alcohol consumption, LDL cholesterol and duration of coronary heart disease without previous percutaneous coronary intervention were predictors of adherence. Conclusions The predictive factors known to explain adherence to treatment were male gender, close personal relationship, longer education, lower LDL cholesterol and longer duration of coronary heart disease without previous percutaneous coronary intervention. Relevance to clinical practice Because a healthy lifestyle predicted factors known to explain adherence, these issues should be emphasised particularly for female patients not in a close personal relationship, with low education and a shorter coronary heart disease duration with previous coronary intervention.

Suggested Citation

  • Outi Kähkönen & Terhi Saaranen & Päivi Kankkunen & Marja‐Leena Lamidi & Helvi Kyngäs & Heikki Miettinen, 2018. "Predictors of adherence to treatment by patients with coronary heart disease after percutaneous coronary intervention," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(5-6), pages 989-1003, March.
    • Handle: RePEc:wly:jocnur:v:27:y:2018:i:5-6:p:989-1003
    DOI: 10.1111/jocn.14153
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    References listed on IDEAS

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    1. Maria Kääriäinen & Merja Paukama & Helvi Kyngäs, 2013. "Adherence with health regimens of patients on warfarin therapy," Journal of Clinical Nursing, John Wiley & Sons, vol. 22(1-2), pages 89-96, January.
    2. Brid Kilonzo & Rhona O’Connell, 2011. "Secondary prevention and learning needs post percutaneous coronary intervention (PCI): perspectives of both patients and nurses," Journal of Clinical Nursing, John Wiley & Sons, vol. 20(7‐8), pages 1160-1167, April.
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    Cited by:

    1. Jiyoung Kim & Nayeon Shin & Kyungmi Lee, 2021. "Development and evaluation of the Coronary Artery Disease Empowerment Scale (CADES) in Korea," Clinical Nursing Research, , vol. 30(8), pages 1241-1250, November.
    2. Wei Liang & Danni Zuo & Master Candidate & Tangyihua Li & Huihua Zhao, 2021. "Patient-Readiness for Discharge and 30-Day Adherence to Treatment After Coronary Stent Implantation," Clinical Nursing Research, , vol. 30(8), pages 1271-1280, November.

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