Improving the Adherence to Medications After Myocardial Infarction
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Every year about one million Americans experience myocardial infarction (MI) and approximately two-thirds survive the acute phase of MI. The combination of a beta-blocker, a lipid-lowering agent, an angiotensin converting enzynle (ACE) inhibitor or angiotensin receptor blocker (ARB), and aspirin are recommended after MI to reduce the risk of coronary artery disease (CAD) mortality. Non-adherence to prescribed medicines following MI remains a common issue and is associated with increased morbidity and mortality. This paper analyzes literature obtained from several databases summarizing available knowledge about factors contributing to non-adherence, consequences of poor adherence to post-MI medications, and interventions to improve patients' adherence to taking medications after MI. Common factors that contribute to non-adherence to prescribed medicines following MI are depression, presence of comorbid chronic diseases, high cost of medications, medication regimen complexity, patients' fear of the potential adverse effects, and the absence of instant benefits. To improve health outcomes in patients after MI, advanced practice nurses can facilitate better adherence to post-MI medications by prescribing once-daily agents, scheduling regular follow-up visits to review medicine use, educating about medications side effects, encouraging use of a multicompartment dose administration aid, assessing and treating patients for depression, and managing patients' chronic diseases.