Medication adherence and target Achievement post-myocardial infarction

Abstract

Background: Medication adherence and secondary prevention target attainment, such as LDL-C and blood pressure control, are critical in reducing recurrent cardiovascular events post-myocardial infarction. How- ever, adherence rates decline over time, and follow-up attendance disparities may impact clinical outcomes. This study examines factors influencing medication adherence, follow-up attendance, and target achieve- ment in post-myocardial infarction patients. Methods: This study included a retrospective analysis of 303 post-MI patients followed for one year, while a prospective study assessed 37 patients at two weeks, and 12 patients at four months post-MI. For the retrospective part, LDL-C and blood pressure attainment were analyzed based on the ESC guidelines. For the prospective part, medication adherence was evaluated using the Medication Adherence Report Scale (MARS), and beliefs about medication were assessed using the Beliefs About Medicines Questionnaire (BMQ). Results: In the prospective study (n = 37), self-reported medication adherence was high, yet 27% of patients were ambivalent about their medication. In the retrospective study, LDL-C target (≤1.8 mmol/L) was achieved by 71.3% of patients at one year (vs 43.4%, before myocardial infarction). Predictors of LDL-C attainment included male sex (OR: 2.81, p<0.001) and hypercholesterolemia at baseline (OR: 0.44, p=0.006). Systolic blood pressure target was achieved in 47.8% after one year (vs 64.3% two weeks post- MI), and 66.9% the diastolic blood pressure target one year post-MI (vs 78.6% two weeks post-MI). Conclusions: Addressing medication concerns and improving follow-up accessibility are essential for en- hancing medication adherence, target achievement and therefore improving clinical outcomes. Future re- search should integrate objective adherence measures and extend follow-up duration for more accurate as- sessment. Intro