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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2018

Open Access 01-12-2018 | Research

Relationships among medication adherence, lifestyle modification, and health-related quality of life in patients with acute myocardial infarction: a cross-sectional study

Authors: Yu-Mi Lee, Rock Bum Kim, Hey Jean Lee, Keonyeop Kim, Min-Ho Shin, Hyeung-Keun Park, Soon-Ki Ahn, So Young Kim, Young-Hoon Lee, Byoung-Gwon Kim, Heeyoung Lee, Won Kyung Lee, Kun Sei Lee, Mi-Ji Kim, Ki-Soo Park

Published in: Health and Quality of Life Outcomes | Issue 1/2018

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Abstract

Background

The healthy adherer effect is a phenomenon in which patients who adhere to medical therapies tend to pursue health-seeking behaviors. Although the healthy adherer effect is supposed to affect health outcomes in patients with coronary artery disease, evaluation of its presence and extent is not easy. This study aimed to assess the relationship between medication adherence and lifestyle modifications and health-related quality of life among post-acute myocardial infarction (AMI) patients.

Methods

A cross-sectional study was conducted in 417 post-AMI patients who underwent percutaneous coronary intervention (PCI). Patients were recruited from 11 university hospitals from December 2015 to March 2016 in South Korea. Details regarding socio-demographic factors, six health behaviors (low-salt intake, low-fat diet and/or weight-loss diet, regular exercise, stress reduction in daily life, drinking in moderation, and smoking cessation), medication adherence using the Modified Morisky Scale (MMS), and HRQoL using the Coronary Revascularization Outcome Questionnaire (CROQ) were surveyed in a one-on-one interview.

Results

In the univariate logistic analysis, sex (female), age (≥70 years), MMS score (≥5), and CROQ score were associated with adherence to lifestyle modification. In the multiple logistic analysis, a high MMS score (≥5) was associated with adherence to lifestyle modification after adjusting for sex, age, marital status, education, and family income (adjusted odds ratio [OR] = 11.7, 95% confidence interval [CI] = 1.5–91.3). After further adjusting for the CROQ score, the association between high MMS score and adherence to lifestyle modification was significant (adjusted OR = 11.5, 95% CI = 1.4–93.3).

Conclusions

Adherence to medication was associated with adherence to lifestyle modification, suggesting the possible presence of the healthy adherer effect in post-AMI patients. After further adjusting for HRQoL, the association remained. To improve health outcome in post-AMI patients, early detection of patients with poor adherence to medication and lifestyle modification and motivational education programs to improve adherence are important. In addition, the healthy adherer effect should be considered in clinical research, in particular, in studies evaluating the effects of therapies on health outcomes.
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Literature
1.
Smith SC Jr, Benjamin EJ, Bonow RO, Braun LT, Creager MA, Franklin BA, Gibbons RJ, Grundy SM, Hiratzka LF, Jones DW, et al. AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and other Atherosclerotic Vascular Disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation. Circulation. 2011;124:2458–73.CrossRefPubMed
2.
O'Gara PT, Kushner FG, Ascheim DD, Casey DE Jr, Chung MK, de Lemos JA, Ettinger SM, Fang JC, Fesmire FM, Franklin BA, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013;127:e362–425.CrossRefPubMed
3.
Mukherjee D, Fang J, Chetcuti S, Moscucci M, Kline-Rogers E, Eagle KA. Impact of combination evidence-based medical therapy on mortality in patients with acute coronary syndromes. Circulation. 2004;109:745–9.CrossRefPubMed
4.
Clark AM, Hartling L, Vandermeer B, McAlister FA. Meta-analysis: secondary prevention programs for patients with coronary artery disease. Ann Intern Med. 2005;143:659–72.CrossRefPubMed
5.
Shrank WH, Patrick AR, Brookhart MA. Healthy user and related biases in observational studies of preventive interventions: a primer for physicians. J Gen Intern Med. 2011;26:546–50.CrossRefPubMedPubMedCentral
6.
Silverman SL, Gold DT. Healthy users, healthy adherers, and healthy behaviors? J Bone Miner Res. 2011;26:681–2.CrossRefPubMed
7.
Di Bartolomeo S, Marino M, Guastaroba P, Valent F, De Palma R. Self-controlled case-series study to verify the effect of adherence to Beta-blockers in secondary prevention of myocardial infarction. J Am Heart Assoc. 2015;4:e001575.CrossRefPubMedPubMedCentral
8.
Lavikainen P, Helin-Salmivaara A, Eerola M, Fang G, Hartikainen J, Huupponen R, Korhonen MJ. Statin adherence and risk of acute cardiovascular events among women: a cohort study accounting for time-dependent confounding affected by previous adherence. BMJ Open. 2016;6:e011306.CrossRefPubMedPubMedCentral
9.
Bansilal S, Castellano JM, Garrido E, Wei HG, Freeman A, Spettell C, Garcia-Alonso F, Lizano I, Arnold RJ, Rajda J. Assessing the impact of medication adherence on long-term cardiovascular outcomes. J Am Coll Cardiol. 2016;68:789–801.CrossRefPubMed
10.
Hansen TB, Thygesen LC, Zwisler AD, Helmark L, Hoogwegt M, Versteeg H, Höfer S, Oldridge N. Self-reported health-related quality of life predicts 5-year mortality and hospital readmissions in patients with ischaemic heart disease. Eur J Prev Cardiol. 2015;22:882–9.CrossRefPubMed
11.
Höfer S, Benzer W, Oldridge N. Change in health-related quality of life in patients with coronary artery disease predicts 4-year mortality. Int J Cardiol. 2014;174:7–12.CrossRefPubMed
12.
Székely A, Nussmeier NA, Miao Y, Huang K, Levin J, Feierfeil H, Mangano DT. A multinational study of the influence of health-related quality of life on in-hospital outcome after coronary artery bypass graft surgery. Am Heart J. 2011;161:1179–85. e1172CrossRefPubMed
13.
Pedersen SS, Martens EJ, Denollet J, Appels A. Poor health-related quality of life is a predictor of early, but not late, cardiac events after percutaneous coronary intervention. Psychosomatics. 2007;48:331–7.CrossRefPubMed
14.
Rumsfeld JS, Alexander KP, Goff DC, Graham MM, Ho PM, Masoudi FA, Moser DK, Roger VL, Slaughter MS, Smolderen KG. Cardiovascular health: the importance of measuring patient-reported health status: a scientific statement from the American Heart Association. Circulation. 2013;127:2233–49.CrossRefPubMed
15.
Uchmanowicz I, Loboz-Grudzien K. Factors influencing quality of life up to the 36th month follow-up after treatment of acute coronary syndrome by coronary angioplasty. Nurs Res Rev. 2015;5:23–31.CrossRef
16.
Darvishpour A, Javadi-Pashaki N, Salari A, Sadeghi T, Taleshan-Nejad M. Factors associated with quality of life in patients undergoing coronary angioplasty. Int J Health Sci (Qassim). 2017;11:35–41.
17.
Spertus JA, Salisbury AC, Jones PG, Conaway DG, Thompson RC. Predictors of quality-of-life benefit after percutaneous coronary intervention. Circulation. 2004;110:3789–94.CrossRefPubMed
18.
Soo Hoo SY, Gallagher R, Elliott D. Systematic review of health-related quality of life in older people following percutaneous coronary intervention. Nurs Health Sci. 2014;16:415–27.CrossRefPubMed
19.
Kang K, Gholizadeh L, Inglis SC, Han HR. Correlates of health-related quality of life in patients with myocardial infarction: A literature review. Int J Nurs Stud. 2017;73:1–16.CrossRefPubMed
20.
Fogel J, Fauerbach JA, Ziegelstein RC, Bush DE. Quality of life in physical health domains predicts adherence among myocardial infarction patients even after adjusting for depressive symptoms. J Psychosom Res. 2004;56:75–82.CrossRefPubMed
21.
Hasandokht T, Salari A, Mirbolouk F, Rajati F, Ashouri A. Medication adherence and quality of life in coronary artery bypass grafting patients, results of retrospective cohort study. Anatol J Cardio. 2016;16:895.
22.
Booth JN 3rd, Levitan EB, Brown TM, Farkouh ME, Safford MM, Muntner P. Effect of sustaining lifestyle modifications (nonsmoking, weight reduction, physical activity, and mediterranean diet) after healing of myocardial infarction, percutaneous intervention, or coronary bypass (from the REasons for Geographic and Racial Differences in Stroke Study). Am J Cardiol. 2014;113:1933–40.CrossRefPubMedPubMedCentral
23.
Chow CK, Jolly S, Rao-Melacini P, Fox KA, Anand SS, Yusuf S. Association of diet, exercise, and smoking modification with risk of early cardiovascular events after acute coronary syndromes. Circulation. 2010;121:750–8.CrossRefPubMed
24.
Sverre E, Peersen K, Husebye E, Gjertsen E, Gullestad L, Moum T, Otterstad JE, Dammen T, Munkhaugen J. Unfavourable risk factor control after coronary events in routine clinical practice. BMC Cardiovasc Disord. 2017;17:40.CrossRefPubMedPubMedCentral
25.
Mathews R, Peterson ED, Honeycutt E, Chin CT, Effron MB, Zettler M, Fonarow GC, Henry TD, Wang TY. Early Medication Nonadherence After Acute Myocardial Infarction: Insights into Actionable Opportunities From the TReatment with ADP receptor iNhibitorS: Longitudinal Assessment of Treatment Patterns and Events after Acute Coronary Syndrome (TRANSLATE-ACS) Study. Circ Cardiovasc Qual Outcomes. 2015;8:347–56.CrossRefPubMedPubMedCentral
26.
Ladova K, Vlcek J, Vytrisalova M, Maly J. Healthy adherer effect - the pitfall in the interpretation of the effect of medication adherence on health outcomes. J Eval Clin Pract. 2014;20:111–6.CrossRefPubMed
27.
Hays RD. The Medical Outcomes Study (MOS) measures of patient adherence. Retrieved April. 1994;19:2004.
28.
Sabaté E, Organization WH: Adherence to long-term therapies: policy for action: meeting report, 4-5 June 2001. 2001.
29.
Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986;24:67–74.CrossRefPubMed
30.
Morisky DE, Levine DM, Green LW, Shapiro S, Russell RP, Smith CR. Five-year blood pressure control and mortality following health education for hypertensive patients. Am J Public Health. 1983;73:153–62.CrossRefPubMedPubMedCentral
31.
Kim S, Kim M, Yoo T, Huh B. Concurrent validity of the Korea version of self-reported questionnaire. J Korean Acad Fam Med. 1995;16:172–9.
32.
Case_Management_Society_of_America. Case management adherence guidelines. Guidelines from the Case Management Society of America for improving patient adherence to medication therapies; 2006. p. 39–41.
33.
Kim S-O. Medication adherence of elderly with hypertension and/or diabetes-mellitus and its' influencing factors. Korean J Clin Pharm. 2011;21:81–9.
34.
Schroter S, Lamping DL. Coronary revascularisation outcome questionnaire (CROQ): development and validation of a new, patient based measure of outcome in coronary bypass surgery and angioplasty. Heart. 2004;90:1460–6.CrossRefPubMedPubMedCentral
35.
36.
Kim M, Seo J, Hwang JY, Park KS. Reliability and validity of the Korean version of the coronary revascularization outcome questionnaire. Health Qual Life Outcomes. 2017;15:37.CrossRefPubMedPubMedCentral
37.
Jackevicius CA, Li P, Tu JV. Prevalence, predictors, and outcomes of primary nonadherence after acute myocardial infarction. Circulation. 2008;117:1028–36.CrossRefPubMed
38.
Cohen A, Assyag P, Boyer-Chatenet L, Cohen-Solal A, Perdrix C, Dalichampt M, Michel P-L, Montalescot G, Ravaud P, Steg PG. An education program for risk factor management after an acute coronary syndrome: a randomized clinical trial. JAMA Intern Med. 2014;174:40–8.CrossRefPubMed
39.
Swieczkowski D, Mogielnicki M, Cwalina N, Zuk G, Pisowodzka I, Ciecwierz D, Gruchala M, Jaguszewski M. Medication adherence in patients after percutaneous coronary intervention due to acute myocardial infarction: From research to clinical implications. Cardiol J. 2016;23:483–90.
40.
Cheng K, Ingram N, Keenan J, Choudhury RP. Evidence of poor adherence to secondary prevention after acute coronary syndromes: possible remedies through the application of new technologies. Open Heart. 2015;2:e000166.CrossRefPubMedPubMedCentral
41.
Griffo R, Ambrosetti M, Tramarin R, Fattirolli F, Temporelli PL, Vestri AR, De Feo S, Tavazzi L, investigators I. Effective secondary prevention through cardiac rehabilitation after coronary revascularization and predictors of poor adherence to lifestyle modification and medication. Results of the ICAROS Survey. Int J Cardiol. 2013;167:1390–5.CrossRefPubMed
42.
Huffman JC, Moore SV, DuBois CM, Mastromauro CA, Suarez L, Park ER. An exploratory mixed methods analysis of adherence predictors following acute coronary syndrome. Psychol Health Med. 2015;20:541–50.CrossRefPubMed
43.
Metadata
Title
Relationships among medication adherence, lifestyle modification, and health-related quality of life in patients with acute myocardial infarction: a cross-sectional study
Authors
Yu-Mi Lee
Rock Bum Kim
Hey Jean Lee
Keonyeop Kim
Min-Ho Shin
Hyeung-Keun Park
Soon-Ki Ahn
So Young Kim
Young-Hoon Lee
Byoung-Gwon Kim
Heeyoung Lee
Won Kyung Lee
Kun Sei Lee
Mi-Ji Kim
Ki-Soo Park
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2018
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-018-0921-z

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