Low-dose Aspirin adherence after acute coronary syndrome – patients` experience

Goranka Petricek, Martina Beljan

Keywords: qualitative research, adherence, acute coronary syndrome, low-dose Aspirin, patients` experience

Background:

Cardiovascular diseases are the leading cause of death worldwide. To prevent cardiovascular morbidity and mortality, low-dose Aspirin (LDA) treatment is among the most widely used treatment. Still, adherence to LDA is suboptimal, with the lowest rates among all cardiovascular preventive therapies.

Research questions:

To explore and describe the patients experience with recurrent acute coronary syndrome (ACS) in the city of Karlovac with regard to factors affecting LDA adherence.

Method:

Four general/family practitioner (GP/FP) recruited 25 patients with recurrent ACS, using a purposeful sampling strategy. Three focus groups were conducted, transcribed and analyzed to find emerging themes and sub-themes. Textual data were explored inductively, using content analysis to generate categories and explanations.

Results:

Seven major themes and explanatory models of lay people’s perspective emerged from the data: factors affecting adherence to LDA (factors related to medication, health professionals and patients) and patients’ expectations of the GP/FP. The majority of participants showed a satisfactory level on the LDA action knowledge. Negative adherence factors involved mostly polypharmacy, multimorbidity and side effects of LDA. The most important positive factors of LDA adherence included patient education by health professionals, followed by trust, availability and continuity of GP/FP care. Other positive factors were family support, personal motivation to live and stay healthy, and technical aids (so-called medication organizers). In contrast, the participants’ job, duties and responsibilities were in some cases indicated as aggravating factors.

Conclusions:

To achieve good adherence to LDA, GPs are advised to provide continuous care to patients who suffered an ACS as part of their everyday work, and to make themselves available to patients through various types of consultations. It is also recommended to build a therapeutic relationship with patients based on trust, establish appropriate communication, refer patients to hospital specialists as required and periodically refresh knowledge about LDA and the reasons for its use.

Points for discussion:

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