Medication adherence, biological and lifestyle risk factors in patients with myocardial infarction: a ten-year follow-up on socially differentiated cardiac rehabilitation
Objective: There is strong evidence that medication adherence and lifestyle changes are essential in patients undergoing secondary cardiovascular disease prevention. Cardiac rehabilitation (CR) increases medication adherence and improves lifestyle changes. Patients with cardiac diseases and a low ed...
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| Veröffentlicht in: | Scandinavian journal of primary health care 2019-04, Vol.37 (2), p.182-190 |
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| creator | Hald, Kathrine Larsen, Finn Breinholt Nielsen, Kirsten Melgaard Meillier, Lucette Kirsten Johansen, Martin Berg Larsen, Mogens Lytken Christensen, Bo Nielsen, Claus Vinther |
| description | Objective: There is strong evidence that medication adherence and lifestyle changes are essential in patients undergoing secondary cardiovascular disease prevention. Cardiac rehabilitation (CR) increases medication adherence and improves lifestyle changes. Patients with cardiac diseases and a low educational level and patients with little social support are less responsive to improve medication adherence and to adapt lifestyle changes. The aim of the present study was to investigate the long-term effects of a socially differentiated CR intervention on medication adherence as well as changes in biological and lifestyle risk factors at two- five- and ten-year follow-up.
Design: A prospective cohort study.
Setting: The cardiac ward at Aarhus University Hospital, Denmark.
Intervention: A socially differentiated CR intervention in addition to the standard CR program.
Subjects: Patients admitted with first-episode myocardial infarction between 2000 and 2004, N = 379. Patients were defined as socially vulnerable or non-socially vulnerable according to their educational level and extent of social network.
Main outcome measures: Primary outcome was medication adherence to antithrombotics, beta-blockers, statins and angiotensin-converting enzyme inhibitors. Secondary outcomes were biological and lifestyle risk factors defined as; total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, glycated hemoglobin, blood pressure and smoking status.
Results: No significant long-term effect of the intervention was found.
Conclusions: The results indicate a non-significant effect of the intervention. However, it was found that equality in health was improved in the study population except concerning smoking. General practitioners manage to support the long-term secondary cardiovascular disease prevention in all patients regardless of social status.
Key points
The socially differentiated intervention did not significantly improve medication adherence or biological and lifestyle risk factors.
Despite the non-significant effect of the intervention, equality in health was improved except concerning smoking.
General practitioners managed to support the long-term secondary cardiovascular disease prevention in all patients regardless of social status. |
| doi_str_mv | 10.1080/02813432.2019.1608046 |
| format | Article |
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Design: A prospective cohort study.
Setting: The cardiac ward at Aarhus University Hospital, Denmark.
Intervention: A socially differentiated CR intervention in addition to the standard CR program.
Subjects: Patients admitted with first-episode myocardial infarction between 2000 and 2004, N = 379. Patients were defined as socially vulnerable or non-socially vulnerable according to their educational level and extent of social network.
Main outcome measures: Primary outcome was medication adherence to antithrombotics, beta-blockers, statins and angiotensin-converting enzyme inhibitors. Secondary outcomes were biological and lifestyle risk factors defined as; total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, glycated hemoglobin, blood pressure and smoking status.
Results: No significant long-term effect of the intervention was found.
Conclusions: The results indicate a non-significant effect of the intervention. However, it was found that equality in health was improved in the study population except concerning smoking. General practitioners manage to support the long-term secondary cardiovascular disease prevention in all patients regardless of social status.
Key points
The socially differentiated intervention did not significantly improve medication adherence or biological and lifestyle risk factors.
Despite the non-significant effect of the intervention, equality in health was improved except concerning smoking.
General practitioners managed to support the long-term secondary cardiovascular disease prevention in all patients regardless of social status.</description><identifier>ISSN: 0281-3432</identifier><identifier>EISSN: 1502-7724</identifier><identifier>DOI: 10.1080/02813432.2019.1608046</identifier><identifier>PMID: 31122102</identifier><language>eng</language><publisher>United States: Taylor & Francis</publisher><subject>Academic achievement ; Adherence ; Aged ; Beta blockers ; Biomarkers - blood ; Blood Pressure ; Cardiac Rehabilitation ; Cardiovascular Agents - therapeutic use ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - blood ; Cardiovascular Diseases - etiology ; Cardiovascular Diseases - prevention & control ; Change agents ; Cholesterol ; Cholesterol - blood ; Cohort analysis ; Denmark ; Density ; Disease prevention ; Drugs ; Equality ; Family physicians ; Female ; Follow-Up Studies ; Glycated Hemoglobin A - metabolism ; Health Equity ; Heart attacks ; Hemoglobin ; Humans ; Intervention ; Life Style ; Lifestyles ; Long term ; Male ; Medication Adherence ; Middle Aged ; Myocardial infarction ; Myocardial Infarction - rehabilitation ; Patient compliance ; Prospective Studies ; Rehabilitation ; risk factor management ; Risk Factors ; Secondary Prevention ; Smoking ; Social status ; Social Support ; Socioeconomic Factors</subject><ispartof>Scandinavian journal of primary health care, 2019-04, Vol.37 (2), p.182-190</ispartof><rights>2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. 2019</rights><rights>2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This work is licensed under the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. 2019 The Author(s)</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c562t-97b9382c83ab471b7e93d9ec5a9a4690bc4f17287fa7b7a0c74f95f8db8468e83</citedby><cites>FETCH-LOGICAL-c562t-97b9382c83ab471b7e93d9ec5a9a4690bc4f17287fa7b7a0c74f95f8db8468e83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6566981/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6566981/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,12846,27502,27924,27925,30999,53791,53793,59143,59144</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31122102$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hald, Kathrine</creatorcontrib><creatorcontrib>Larsen, Finn Breinholt</creatorcontrib><creatorcontrib>Nielsen, Kirsten Melgaard</creatorcontrib><creatorcontrib>Meillier, Lucette Kirsten</creatorcontrib><creatorcontrib>Johansen, Martin Berg</creatorcontrib><creatorcontrib>Larsen, Mogens Lytken</creatorcontrib><creatorcontrib>Christensen, Bo</creatorcontrib><creatorcontrib>Nielsen, Claus Vinther</creatorcontrib><title>Medication adherence, biological and lifestyle risk factors in patients with myocardial infarction: a ten-year follow-up on socially differentiated cardiac rehabilitation</title><title>Scandinavian journal of primary health care</title><addtitle>Scand J Prim Health Care</addtitle><description>Objective: There is strong evidence that medication adherence and lifestyle changes are essential in patients undergoing secondary cardiovascular disease prevention. Cardiac rehabilitation (CR) increases medication adherence and improves lifestyle changes. Patients with cardiac diseases and a low educational level and patients with little social support are less responsive to improve medication adherence and to adapt lifestyle changes. The aim of the present study was to investigate the long-term effects of a socially differentiated CR intervention on medication adherence as well as changes in biological and lifestyle risk factors at two- five- and ten-year follow-up.
Design: A prospective cohort study.
Setting: The cardiac ward at Aarhus University Hospital, Denmark.
Intervention: A socially differentiated CR intervention in addition to the standard CR program.
Subjects: Patients admitted with first-episode myocardial infarction between 2000 and 2004, N = 379. Patients were defined as socially vulnerable or non-socially vulnerable according to their educational level and extent of social network.
Main outcome measures: Primary outcome was medication adherence to antithrombotics, beta-blockers, statins and angiotensin-converting enzyme inhibitors. Secondary outcomes were biological and lifestyle risk factors defined as; total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, glycated hemoglobin, blood pressure and smoking status.
Results: No significant long-term effect of the intervention was found.
Conclusions: The results indicate a non-significant effect of the intervention. However, it was found that equality in health was improved in the study population except concerning smoking. General practitioners manage to support the long-term secondary cardiovascular disease prevention in all patients regardless of social status.
Key points
The socially differentiated intervention did not significantly improve medication adherence or biological and lifestyle risk factors.
Despite the non-significant effect of the intervention, equality in health was improved except concerning smoking.
General practitioners managed to support the long-term secondary cardiovascular disease prevention in all patients regardless of social status.</description><subject>Academic achievement</subject><subject>Adherence</subject><subject>Aged</subject><subject>Beta blockers</subject><subject>Biomarkers - blood</subject><subject>Blood Pressure</subject><subject>Cardiac Rehabilitation</subject><subject>Cardiovascular Agents - therapeutic use</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Cardiovascular Diseases - blood</subject><subject>Cardiovascular Diseases - etiology</subject><subject>Cardiovascular Diseases - prevention & control</subject><subject>Change agents</subject><subject>Cholesterol</subject><subject>Cholesterol - blood</subject><subject>Cohort analysis</subject><subject>Denmark</subject><subject>Density</subject><subject>Disease prevention</subject><subject>Drugs</subject><subject>Equality</subject><subject>Family physicians</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glycated Hemoglobin A - metabolism</subject><subject>Health Equity</subject><subject>Heart attacks</subject><subject>Hemoglobin</subject><subject>Humans</subject><subject>Intervention</subject><subject>Life Style</subject><subject>Lifestyles</subject><subject>Long term</subject><subject>Male</subject><subject>Medication Adherence</subject><subject>Middle Aged</subject><subject>Myocardial infarction</subject><subject>Myocardial Infarction - rehabilitation</subject><subject>Patient compliance</subject><subject>Prospective Studies</subject><subject>Rehabilitation</subject><subject>risk factor management</subject><subject>Risk Factors</subject><subject>Secondary Prevention</subject><subject>Smoking</subject><subject>Social status</subject><subject>Social Support</subject><subject>Socioeconomic Factors</subject><issn>0281-3432</issn><issn>1502-7724</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>0YH</sourceid><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>DOA</sourceid><recordid>eNp9ks1uEzEUhUcIREvgEUCW2LBggu3xjMcsKlDFT6UiNrC27vgncXDGwXaI5pV4SjxNWlEWrCzd-51zbd9TVc8JXhLc4zeY9qRhDV1STMSSdKXGugfVOWkxrTmn7GF1PjP1DJ1VT1LaYEx6LJrH1VlDCKUE0_Pq9xejnYLswohAr000ozKv0eCCD6vS8AhGjbyzJuXJGxRd-oEsqBxiQm5EuyI1Y07o4PIabaegIGpXZG60ENXs-xYBymasJwMR2eB9ONT7HSoDU1AF9RPSztp5dHaQjUZHD4WiWcPgvMs393taPbLgk3l2OhfV948fvl1-rq-_frq6fH9dq7ajuRZ8EE1PVd_AwDgZuBGNFka1IIB1Ag-KWcJpzy3wgQNWnFnR2l4PPet60zeL6uroqwNs5C66LcRJBnDyphDiSkLMTnkj8cA0sUZxKoq47QUjzADuO0w7YYUuXhdHr91-2BqtyhMj-Hum9zujW8tV-CW7tutE2fCienUyiOHnvixBbl1SxnsYTdgnSWlDCeVN1xb05T_oJuzjWL6qULzDLSOEFao9UiqGlKKxd5chWM7JkrfJknOy5ClZRffi75fcqW6jVIB3R6BsPsQtHEL0WmaYfIg2wqhcKvB_Z_wB9tvg-w</recordid><startdate>20190403</startdate><enddate>20190403</enddate><creator>Hald, Kathrine</creator><creator>Larsen, Finn Breinholt</creator><creator>Nielsen, Kirsten Melgaard</creator><creator>Meillier, Lucette Kirsten</creator><creator>Johansen, Martin Berg</creator><creator>Larsen, Mogens Lytken</creator><creator>Christensen, Bo</creator><creator>Nielsen, Claus Vinther</creator><general>Taylor & Francis</general><general>Taylor & Francis LLC</general><general>Taylor & Francis Group</general><scope>0YH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QJ</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20190403</creationdate><title>Medication adherence, biological and lifestyle risk factors in patients with myocardial infarction: a ten-year follow-up on socially differentiated cardiac rehabilitation</title><author>Hald, Kathrine ; Larsen, Finn Breinholt ; Nielsen, Kirsten Melgaard ; Meillier, Lucette Kirsten ; Johansen, Martin Berg ; Larsen, Mogens Lytken ; Christensen, Bo ; Nielsen, Claus Vinther</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c562t-97b9382c83ab471b7e93d9ec5a9a4690bc4f17287fa7b7a0c74f95f8db8468e83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Academic achievement</topic><topic>Adherence</topic><topic>Aged</topic><topic>Beta blockers</topic><topic>Biomarkers - blood</topic><topic>Blood Pressure</topic><topic>Cardiac Rehabilitation</topic><topic>Cardiovascular Agents - therapeutic use</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Cardiovascular Diseases - blood</topic><topic>Cardiovascular Diseases - etiology</topic><topic>Cardiovascular Diseases - prevention & control</topic><topic>Change agents</topic><topic>Cholesterol</topic><topic>Cholesterol - blood</topic><topic>Cohort analysis</topic><topic>Denmark</topic><topic>Density</topic><topic>Disease prevention</topic><topic>Drugs</topic><topic>Equality</topic><topic>Family physicians</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glycated Hemoglobin A - metabolism</topic><topic>Health Equity</topic><topic>Heart attacks</topic><topic>Hemoglobin</topic><topic>Humans</topic><topic>Intervention</topic><topic>Life Style</topic><topic>Lifestyles</topic><topic>Long term</topic><topic>Male</topic><topic>Medication Adherence</topic><topic>Middle Aged</topic><topic>Myocardial infarction</topic><topic>Myocardial Infarction - rehabilitation</topic><topic>Patient compliance</topic><topic>Prospective Studies</topic><topic>Rehabilitation</topic><topic>risk factor management</topic><topic>Risk Factors</topic><topic>Secondary Prevention</topic><topic>Smoking</topic><topic>Social status</topic><topic>Social Support</topic><topic>Socioeconomic Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hald, Kathrine</creatorcontrib><creatorcontrib>Larsen, Finn Breinholt</creatorcontrib><creatorcontrib>Nielsen, Kirsten Melgaard</creatorcontrib><creatorcontrib>Meillier, Lucette Kirsten</creatorcontrib><creatorcontrib>Johansen, Martin Berg</creatorcontrib><creatorcontrib>Larsen, Mogens Lytken</creatorcontrib><creatorcontrib>Christensen, Bo</creatorcontrib><creatorcontrib>Nielsen, Claus Vinther</creatorcontrib><collection>Taylor & Francis Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Scandinavian journal of primary health care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hald, Kathrine</au><au>Larsen, Finn Breinholt</au><au>Nielsen, Kirsten Melgaard</au><au>Meillier, Lucette Kirsten</au><au>Johansen, Martin Berg</au><au>Larsen, Mogens Lytken</au><au>Christensen, Bo</au><au>Nielsen, Claus Vinther</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Medication adherence, biological and lifestyle risk factors in patients with myocardial infarction: a ten-year follow-up on socially differentiated cardiac rehabilitation</atitle><jtitle>Scandinavian journal of primary health care</jtitle><addtitle>Scand J Prim Health Care</addtitle><date>2019-04-03</date><risdate>2019</risdate><volume>37</volume><issue>2</issue><spage>182</spage><epage>190</epage><pages>182-190</pages><issn>0281-3432</issn><eissn>1502-7724</eissn><abstract>Objective: There is strong evidence that medication adherence and lifestyle changes are essential in patients undergoing secondary cardiovascular disease prevention. Cardiac rehabilitation (CR) increases medication adherence and improves lifestyle changes. Patients with cardiac diseases and a low educational level and patients with little social support are less responsive to improve medication adherence and to adapt lifestyle changes. The aim of the present study was to investigate the long-term effects of a socially differentiated CR intervention on medication adherence as well as changes in biological and lifestyle risk factors at two- five- and ten-year follow-up.
Design: A prospective cohort study.
Setting: The cardiac ward at Aarhus University Hospital, Denmark.
Intervention: A socially differentiated CR intervention in addition to the standard CR program.
Subjects: Patients admitted with first-episode myocardial infarction between 2000 and 2004, N = 379. Patients were defined as socially vulnerable or non-socially vulnerable according to their educational level and extent of social network.
Main outcome measures: Primary outcome was medication adherence to antithrombotics, beta-blockers, statins and angiotensin-converting enzyme inhibitors. Secondary outcomes were biological and lifestyle risk factors defined as; total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, glycated hemoglobin, blood pressure and smoking status.
Results: No significant long-term effect of the intervention was found.
Conclusions: The results indicate a non-significant effect of the intervention. However, it was found that equality in health was improved in the study population except concerning smoking. General practitioners manage to support the long-term secondary cardiovascular disease prevention in all patients regardless of social status.
Key points
The socially differentiated intervention did not significantly improve medication adherence or biological and lifestyle risk factors.
Despite the non-significant effect of the intervention, equality in health was improved except concerning smoking.
General practitioners managed to support the long-term secondary cardiovascular disease prevention in all patients regardless of social status.</abstract><cop>United States</cop><pub>Taylor & Francis</pub><pmid>31122102</pmid><doi>10.1080/02813432.2019.1608046</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | Scandinavian journal of primary health care, 2019-04, Vol.37 (2), p.182-190 |
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| language | eng |
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| source | Taylor & Francis Open Access; MEDLINE; DOAJ Directory of Open Access Journals; Applied Social Sciences Index & Abstracts (ASSIA); EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Academic achievement Adherence Aged Beta blockers Biomarkers - blood Blood Pressure Cardiac Rehabilitation Cardiovascular Agents - therapeutic use Cardiovascular disease Cardiovascular diseases Cardiovascular Diseases - blood Cardiovascular Diseases - etiology Cardiovascular Diseases - prevention & control Change agents Cholesterol Cholesterol - blood Cohort analysis Denmark Density Disease prevention Drugs Equality Family physicians Female Follow-Up Studies Glycated Hemoglobin A - metabolism Health Equity Heart attacks Hemoglobin Humans Intervention Life Style Lifestyles Long term Male Medication Adherence Middle Aged Myocardial infarction Myocardial Infarction - rehabilitation Patient compliance Prospective Studies Rehabilitation risk factor management Risk Factors Secondary Prevention Smoking Social status Social Support Socioeconomic Factors |
| title | Medication adherence, biological and lifestyle risk factors in patients with myocardial infarction: a ten-year follow-up on socially differentiated cardiac rehabilitation |
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