Yongwhi Park1,2, Yong-Hwan Park2,3, Ki-Soo Park4. 1. Department of Internal Medicine, Institute of Health Sciences, College of Medicine, Gyeongsang National University Jinju 52727, Korea. 2. Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon 51472, Korea. 3. Department of Cardiology, Samsung Changwon Medical Center, Changwon 51353, Korea. 4. Department of Preventive Medicine, Institute of Health Sciences, College of Medicine, Gyeongsang National University, 15-816 Jinju-daero, Jinju 52727, Korea.
Abstract
PURPOSE: Non-adherence to medications can be classified as unintentional and intentional. The aim of this study was to establish the major determinants of each non-adherence in myocardial infarction (MI). We also evaluated the effects of non-adherences on healthy behaviors. MATERIALS AND METHODS: We enrolled 510 patients >1 year after MI. Nonadherences classified as unintentional or intentional were measured by a self-reported questionnaire. Polynomial and multiple regression analysis were performed to evaluate the determinant of each type of nonadherences. RESULTS: Among patients with nonadherence, 263 (70.7%) patients were unintentionally non-adherent while 109 (29.3%) patients were intentionally non-adherent. Psychological belief and attitude were important in unintentional non-adherence (Exp(β) = 0.917, p = 0.050 for anxiety; Exp(β) = 1.191, p = 0.001 for concerns). Beliefs about medications were the strongest determinant of intentional non-adherence (Exp(β) = 0.812, p < 0.001 for necessity; Exp(β) = 1.421, p < 0.001 for concerns). Anxiety was important determinant of intentional non-adherence (Exp(β) = 0.889, p = 0.015). CONCLUSION: Psychological factors and beliefs about medication were important determinants of both types of non-adherence. Combined approaches targeting the beliefs about medications and psychological distress are needed to improve drug adherence in patients with MI.
PURPOSE: Non-adherence to medications can be classified as unintentional and intentional. The aim of this study was to establish the major determinants of each non-adherence in myocardial infarction (MI). We also evaluated the effects of non-adherences on healthy behaviors. MATERIALS AND METHODS: We enrolled 510 patients >1 year after MI. Nonadherences classified as unintentional or intentional were measured by a self-reported questionnaire. Polynomial and multiple regression analysis were performed to evaluate the determinant of each type of nonadherences. RESULTS: Among patients with nonadherence, 263 (70.7%) patients were unintentionally non-adherent while 109 (29.3%) patients were intentionally non-adherent. Psychological belief and attitude were important in unintentional non-adherence (Exp(β) = 0.917, p = 0.050 for anxiety; Exp(β) = 1.191, p = 0.001 for concerns). Beliefs about medications were the strongest determinant of intentional non-adherence (Exp(β) = 0.812, p < 0.001 for necessity; Exp(β) = 1.421, p < 0.001 for concerns). Anxiety was important determinant of intentional non-adherence (Exp(β) = 0.889, p = 0.015). CONCLUSION: Psychological factors and beliefs about medication were important determinants of both types of non-adherence. Combined approaches targeting the beliefs about medications and psychological distress are needed to improve drug adherence in patients with MI.