Quality of life of coronary artery disease patients after the implementation of planning strategies for medication adherence

Lourenço, Laura Bacelar de Araujo; Rodrigues, Roberta Cunha Matheus; São-João, Thaís Moreira; Gallani, Maria Cecilia; Cornélio, Marilia Estevam

doi:10.1590/0104-1169.0144.2519

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Revista Latino-Americana de Enfermagem

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Original Articles • Rev. Latino-Am. Enfermagem 23 (1) • Jan-Feb 2015 • https://doi.org/10.1590/0104-1169.0144.2519 copy

Quality of life of coronary artery disease patients after the implementation of planning strategies for medication adherence ¹ 1 Paper extracted from master's thesis "Effect of the action and coping planning in medication adherence and quality of life of patients with coronary hearty disease", presented to Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

to compare the general and specific health-related quality of life (HRQoL) between the Intervention (IG) and Control (CG) groups of coronary artery disease patients after the implementation of Action Planning and Coping Planning strategies for medication adherence and to verify the relationship between adherence and HRQoL.

METHOD:

this was a controlled and randomized study.

RESULTS:

the sample (n=115) was randomized into two groups, IG (n=59) and CG (n=56). Measures of medication adherence and general and specific HRQoL were obtained in the baseline and after two months of monitoring.

CONCLUSION:

the findings showed that the combination of intervention strategies - Action Planning and Coping Planning for medication adherence did not affect the HRQoL of coronary artery disease patients in outpatient monitoring.

Descriptors
Nursing; Medication Adherence; Health Behavior; Planning Techniques; Coronary Disease

Variables			Total Group (n=115)	Intervention Group (N=59)	Control Group (N=56)
Sociodemographic
	Age, Mean (SD*)		62.0 (9.0)	63.4 (8.9)	60.6 (9.0)
	Gender, n (%)
		Male	75 (65.2)	40 (67.8)	35 (62.5)
	Marital Arrangement, n (%)
		With partner	83 (72.2)	44 (74.6)	39 (69.6)
	Education (years), Mean (SD*)		5.8 (4.1)	5.5 (4.0)	6.2 (4.3)
	Habits/Lifestyle, n (%)
		Current smoker (yes)	13 (11.3)	3 (5.1)	10 (17.8)
	Employment Situation, n (%)
		Unemployed	71 (61.7)	44 (74.6)	33 (58.9)
		Employed	31 (26.9)	9 (15.2)	22 (39.3)
		Housewife/husband	10 (8.7)	5 (8.5)	5 (8.9)
	Family income (MW^†), Mean (SD*)		3.0 (3.6)	3.2 (3.6)	2.7 (3.5)
Clinical
	Characterization of coronary disease, n (%)
		Unstable Angina	24 (20.9)	15 (25.4)	9 (16.1)
		Myocardial infarction	91 (79.1)	44 (74.5)	47 (83.9)
	Number of previous infarctions, Mean (SD*)		0.7 (1.1)	1.0 (1.3)^‡	0.5 (0.9)^‡
	Symptoms (in the previous month)^§, n (%)
		Precordialgia	51 (44.3)	31 (52.5)	20 (35.7)
		Dyspnoea	48 (41.7)	24 (40.7)	24 (42.8)
		Lower limb edema	40 (34.8)	23 (39.0)	17 (30.3)
		Palpitations	32 (27.8)	18 (30.5)	14 (25.0)
		Lipothymy	27 (23.5)	16 (27.1)	11 (19.6)
	Number of Associated Clinical Conditions, Mean (SD*)		5.0 (1.8)	5.1 (1.9)	4.8 (1.8)
	Associated Clinical Conditions^§, n (%)
		Dyslipidemia	91 (79.1)	51 (86.4)	40 (71.4)
		Arterial Hypertension	88 (76.5)	50 (84.7)	38 (67.8)
		Diabetes mellitus	41 (35.6)	27 (45.8)	14 (25.0)
	Treatment, n (%)
		Clinical and Intervention (MR^\|\|/MRA^¶/MR^\|\| and MRA^¶)	84 (73.0)	40 (67.4)	44 (78.6)
		Clinical	31 (27.0)	19 (32.2)	12 (21.4)
	Number of medications in use, Mean (SD*)		6.4 (2.0)	6.8 (2.0)	5.9 (1.9)
	Number of Cardioprotective Medications, Mean (SD*)		3.6 (0.6)	3.5 (0.6)	3.7 (0.5)
	Number of Symptom Relief Medications, Mean (SD*)		0.8 (0.7)	0.9 (0.7)	0.8(0.8)
	Total Morisky score, Mean (SD*)		6.9 (2.8)	7.3 (3.1)	6.5 (2.3)
	Proportion of Adherence, Mean (SD*)		92.9 (12.1)	92.1 (13.7)	93.7 (10.2)
	Proportion of Adherence^§, n (%)
		Appropriate dose (≥80%)	53 (89.8)	52 (88.1)	50 (89.3)
		Inappropriate dose (<80%)	6 (10.2)	7 (11.9)	6 (10.7)
	Overall adherence assessment^§, n (%)
		Adherent	27 (23.5)	19 (32.2)	8 (14.3)
		Non-Adherent	88 (76.5)	40 (67.8)	48 (85.7)

		Intervention Group (n=59)			Control Group (n=56)
		T₀	T₂	Mean differences (T₂-T₀)	T₀	T₂	Mean differences (T₂-T₀)
		Mean (SD*)	Mean (SD*)	Mean differences (T₂-T₀)	Mean (SD*)	Mean (SD*)	Mean differences (T₂-T₀)
MacNew
	Physical Functioning	4.8 (1.2)	5.2 (1.1)	0.4^†	5.0 (1.3)	5.3 (1.1)	0.3^‡
	Emotional Functioning	4.9 (1.1)	5.2 (0.9)	0.3^†	5.2 (1.3)	5.4 (1.1)	0.2
	Social Functioning	4.7 (1.2)	5.1 (1.1)	0.4^†	5.0 (1.2)	5.3 (1.1)	0.3^†
	Total	4.8 (1.0)	5.1 (0.9)	0.3^†	5.0 (1.1)	5.3 (1.0)	0.3^†
SF-36
	Functional Capacity	49.1 (22.3)	54.4 (28.7)	5.3^†	55.4 (28.4)	58.4 (27.8)	3.0
	Physical Aspects	39.0 (29.1)	36.9 (38.1)	-2.1	43.7 (40.5)	44.2 (39.3)	0.5
	Pain	55.8 (24.3)	61.2 (25.7)	5.4	56.5 (28.0)	58.5 (27.2)	2.0
	General Health Status	59.0 (20.6)	61.1 (17.4)	2.1	60.2 (21.6)	57.4 (18.7)	-2.8
	Vitality	56.2 (23.2)	56.3 (21.1)	0.1	56.4 (22.9)	54.3 (21.9)	-2.1
	Social Aspects	60.4 (28.0)	70.8 (25.9)	10.4^†	64.3 (29.6)	69.4 (26.6)	5.1
	Emotional Aspects	42.4 (39.1)	51.4 (41.2)	9.0	49.4 (41.2)	55.9 (38.2)	6.5
	Mental Health	61.4 (22.3)	62.4 (19.6)	1.0	63.1 (22.2)	62.6 (21.0)	-0.5

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[1] Corresponding Author: Roberta Cunha Matheus Rodrigues Universidade Estadual de Campinas. Faculdade de Enfermagem Rua Tessália Vieira de Camargo, 126 Cidade Universitária "Zeferino Vaz" CEP: 13083-887, Campinas, SP, Brasil E-mail: rroberta@unicamp.br