Premium
Adherence to secondary prevention therapies in acute coronary syndrome
Author(s) -
Thakkar Jay B,
Chow Clara K
Publication year - 2014
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/mja14.01157
Subject(s) - medicine , psychological intervention , acute coronary syndrome , intensive care medicine , compliance (psychology) , multidisciplinary approach , coronary artery disease , secondary prevention , obedience , physical therapy , myocardial infarction , nursing , psychology , social psychology , social science , sociology
Summary Despite overwhelming evidence of the effectiveness of secondary prevention therapies, surveys indicate poor adherence to medical treatments and lifestyle recommendations after an acute coronary syndrome. The term adherence is preferred over compliance , as the former suggests a therapeutic alliance, whereas the latter reflects passive patient obedience. Poor adherence results from a complex interplay of multiple factors at patient, practitioner and system levels. Poor adherence among patients with stable coronary artery disease is associated with increased risk of cardiovascular admissions (10%–40%), coronary interventions (10%–30%) and cardiovascular mortality (50%–80%). Improving adherence is a complex process. A range of interventions that target modifiable factors influencing adherence have been explored, but there are no guidelines to guide the choice, and multidisciplinary efforts may be needed. Future research in the area should focus on comparative efficacy of interventions to enhance adherence.