Assessment of Adherence to Drug Regimen, it’s Potential Factors and Quality of Life among Patients who have Undergone Myocardial Revascularization Attending Cardiac OPD of NRS Medical College and Hospital of Kolkata, West Bengal

Abstract

Introduction: Quality of life is the ultimate outcome for a patient who has undergone myocardial revascularization. Among several influencing factors, adherence to drug regimen enhances its level by preventing restenosis of stent or graft and restricting the progress of native CAD. Nurse’s role is to assist patient with myocardial revascularization for maintaining high quality of life by exploring the associated issues in a greater extent.

Objectives: The objectives of the study were to assess the level of adherence to drug regimen, to explore potential factors of adherence to drug regimen and to assess quality of life among patients who have undergone myocardial revascularization.

Methodology: A quantitative research approach and prospective longitudinal cohort study design was adopted to collect data from 355 patients who have undergone either PTCA or CABG, selected by nonprobability convenience sampling technique. ARMS, SF-36 short form and an interview schedule were used to collect data from the subject at three months’ interval till 9 months after revascularization.

Result: The study result shows that majority 82% of the patients with myocardial revascularization were adherent to drug regimen at initial month after revascularization but reduced to 52% after nine months (p<0.01). The percentage of adherence with medication was significantly reduced to 74% after 3 months, 75% after 6 months and 59% after 9 months among patients with CABG whereas percentage of adherence among patient with PTCA was also reduced to 66% after 3 months, 63% after 6 months and 44% after 9 months (p<0.01). Age and educational status were independent predictive factors for adherence to drug regimen among patient with PTCA. The potential associated factors related to adherence to drug regimen was no of drugs unavailable at Govt. medicine counter. The two main domains, of quality of life as physical component summary and mental component summary of patient with myocardial revascularization were improved from one month to 9 months after intervention (p<0.001). Physical component summary of quality of life had a negative relationship with adherence to drug regimen at 3 months, 6 months and 9 months’ time period whereas mental component summary of quality of life had a significant negative relationship with adherence to drug regimen at 6 months’ time period.

Conclusion: Adherence to drug regimen was decreased over time but quality of life was improved among patients with myocardial revascularization. There was a positive relationship with adherence to drug regimen with PCS domain of quality of life among patients with myocardial revascularization. Age and educational status were independent predictive or potential factors for adherence to drug regimen among patient with PTCA.