Ali Muhammad Armughan, Yasir Javeria, Sherwani Rida Noor, Fareed Marium, Arshad Fizza, Abid Fareeha, Arshad Ramsha, Ismail Safana, Khan Sarim Ahmed, Siddiqui UroojJamal, Muhammad Marium Gul, Fatima Kaneez
Dow University of Health Sciences (DUHS), Karachi, Pakistan.
Dow University of Health Sciences (DUHS), Karachi, Pakistan.
Indian Heart J. 2017 Jul-Aug;69(4):469-473. doi: 10.1016/j.ihj.2017.05.017. Epub 2017 May 26.
Non-adherence to dietary recommendations, exercise and prescribed drug regimens, in coronary heart disease (CHD) patients following coronary artery bypass grafting (CABG), is a major health care issue worldwide.
The primary objective of this study was to investigate the frequency and predictors of non-adherence to lifestyle changes and medication among CHD patients after undergoing CABG surgery.
The sample of this cross sectional descriptive study was 265 patients who underwent isolated primary CABG. Participants who met the eligibility criteria were provided with a pre-coded questionnaire 4 weeks or more after surgery. Adherence was assessed on the basis of patient's self-report. Significance of results was analyzed using Chi square test.
Roughly half of the patients were non-adherent to dietary recommendations (n=120, 45.3%) and exercise (n=109, 41.1%) while about one third (n=69, 26%) were non-adherent to prescribed medications. Unwillingness to adopt a new lifestyle and more than one social gathering per week, were found to be statistically significant predictors of non-adherence to diet (p-values<0.001). Reluctance to follow exercise regimen, busy schedule, and fear that exercise will aggravate heart issues were commonly reported as reasons for non-compliance to exercise. As for non-adherence to medication, forgetfulness, affordability of drugs and too many medications to take were important predictors.
Non-adherence to lifestyle modifications and medication is an emerging problem worldwide. It is essential for medical health professionals to discuss these predictors and address them individually. Our findings highlight the need for a healthy physician and patient relationship.
冠状动脉搭桥术(CABG)后的冠心病(CHD)患者不遵守饮食建议、运动和规定的药物治疗方案,是全球范围内的一个主要医疗保健问题。
本研究的主要目的是调查冠状动脉搭桥手术后冠心病患者不遵守生活方式改变和药物治疗的频率及预测因素。
本横断面描述性研究的样本为265例行单纯原发性冠状动脉搭桥术的患者。符合纳入标准的参与者在术后4周或更长时间被提供一份预编码问卷。依从性根据患者的自我报告进行评估。结果的显著性采用卡方检验进行分析。
大约一半的患者不遵守饮食建议(n = 120,45.3%)和运动建议(n = 109,41.1%),而约三分之一(n = 69,26%)的患者不遵守规定药物治疗。不愿采用新的生活方式和每周参加不止一次社交聚会,被发现是不遵守饮食的统计学显著预测因素(p值<0.001)。不愿遵循运动方案、日程繁忙以及担心运动会加重心脏问题是常见的不遵守运动的原因。至于不遵守药物治疗,健忘、药物可承受性以及要服用的药物过多是重要的预测因素。
不遵守生活方式改变和药物治疗是全球范围内一个新出现的问题。医疗卫生专业人员讨论这些预测因素并分别加以解决至关重要。我们的研究结果凸显了建立健康医患关系的必要性。