Background: Despite the consistently proven benefits of cardioprotective medications, medication adherence (MA) remains a challenge in coronary artery disease (CAD) patients. Studies suggest that up to 50% of patients with CAD are nonadherent to medications, with patient knowledge, beliefs, and expectations playing a vital role. We aimed to assess patient-related medication non-adherence (MNA) factors in our CAD patients within a large safety net population.
Methods: We obtained data from the electronic record warehouse of an outpatient cardiology clinic between September 31, 2018, and March 31, 2019. Patients with a documented diagnosis of CAD and MNA were identified and their medical records were reviewed. These individuals were called and asked to complete a questionnaire regarding their beliefs about medications. Patients with known depression or cognitive disorder were excluded.
Results: A total of 100 (out of 172 eligible) patients completed the questionnaire. Our study population was mostly African American (97%) with a mean age 63 ± 2. Of those surveyed, 86%, 83%, and 69% were on a beta-blocker, statin, or ace-I/arb respectively. 12% of patients reportedly stopped taking ≥1 of these medications. 12% did not know the appropriate dosing intervals and 27% did not know the medications’ indications. 34% doubted that their medications were beneficial and 25% reported side effects. Patients <50 years of age (n=10) were more likely to have difficulties getting their refills on time (financial or otherwise) (P<.05). Patients on ≥15 home medications (n=15) were more likely to have concerns regarding their medications (P<.05).
Conclusions: Our study provides insight into the importance of analyzing patient beliefs and expectations regarding MA in CAD patients. Addressing the concerns noted from this study may improve MA rates. Future aims include initiating a resident driven initiative to address patient education regarding medication adherence to improve outcomes in patients with CAD.