Medication adherence and patient satisfaction following percutaneous coronary intervention: experience of a tertiary care cardiac center in Sri Lanka

Background: Percutaneous coronary intervention (PCI) is an effective treatment modality of coronary revascularization. Since this is not curative, medication adherence with a better patient satisfaction have a major impact on final clinical outcome. This study aims to assess medication adherence and patient satisfaction following PCI.

 

Method: Total of 145 patients who underwent elective PCI during 2014 and 2015 at Cardiology Unit, Teaching Hospital Kandy, Sri Lanka were followed up. Medication adherence was assessed using Morisky Medication Adherence Scale (MMAS-8). Patient satisfaction was assessed using Patient Satisfaction Questionnaire.

 

Results: Participants’ mean age was 54.97± 8.43 years and 80% (n=116) were males. Mean duration from last myocardial infarction to PCI was 0.89±1.84 years. Number of drugs consumed by a person per day was 7.77±2.33. Majority were on Aspirin (98.6%), Clopidogrel (99.3%) and statins (97.9%). According to MMAS-8, 90% (n=131) were mode-rate to high adherent to treatments. Forgetfulness (44.8%) and inaccessibility of drugs (13.9%) were the commonest reasons for low adherence. Low adherent to dual antiplatelet therapy was 8.3% (n=12). Majority were unaware about duration of Aspirin (78.6%, n=114) and Clopidogrel (85.5%, n=124) therapy. Major or minor bleeding was observed in 9% (n=13) as an adverse effect. There was no significant association of drug non-adherence with adverse effects of drugs (χ2=0.457, p=0.557). Overall satisfaction regarding health care was 95.9% (n=139). Satisfaction about accessibility and convenience of health system was the lowest (46.9%, n=68) with a positive association with male gender (χ2=3.662, p=0.043) and higher education level (χ2=14.741, p<0.001). There was no association between high patient satisfaction and drug adherent (χ2=0.400, p=0.702).

 

 

Conclusion: Majority of patients who underwent PCI had moderate to high adherence to pharmacological therapy. Even with limited resources, health system was able to provide a better PCI facility with high patient’s satisfaction in most number of aspects.