scholarly journals Experience of adherence to treatment among patients with coronary artery disease during the COVID-19 pandemic: A qualitative study

2021 ◽  
Vol 11 (4) ◽  
pp. 467-475
Author(s):  
Nasrin Zahmatkeshan ◽  
Zahra Khademian ◽  
Ladan Zarshenas ◽  
Mahnaz Rakhshan
Keyword(s):  
Coronary Artery Disease ◽  
Content Analysis ◽  
Coronary Artery ◽  
Qualitative Study ◽  
Support Systems ◽  
Qualitative Content Analysis ◽  
Self Care ◽  
Adherence To Treatment ◽  
Artery Disease ◽  
Second Category

Background: The coronavirus disease 2019 (COVID-19) pandemic has caused patients with chronic diseases to face various challenges. The present qualitative study aimed to explore adherence to treatment in patients with coronary artery disease (CAD) during the COVID-19 pandemic. Methods: This qualitative content analysis was conducted from September 2020 to February 2021. Online in-depth interviews were conducted with 15 patients with CAD after discharge from Nemazi and Al-Zahra heart hospitals, Shiraz, Iran. Data management was done via MAXQDA 12 software using conventional content analysis based on the method proposed by Graneheim and Lundman. Results: The results revealed three main categories, nine subcategories, and 431 primary codes. The first category was ‘improved self-care in the shadow of COVID-19‘ (Improving self-care due to fear of COVID-19, ‘utilization of alternative strategies, and reinforcement of self-care beliefs). The second category was ‘redefinition of support systems’ (need for a support system, seeking for alternative support systems, and changes in social interactions). The last category was ‘barriers to treatment adherence’ (shortage of financial resources, need to adjust with working conditions, and mental conflicts). Conclusion: The results indicated that the COVID-19 threats encouraged the patients with CAD to adhere to their care principles. Nonetheless, the restrictions resulting from the pandemic caused problems in adherence to treatment. Thus, redefinition of the support systems in accordance with the present conditions are recommended.

scholarly journals Self-Care Behaviors of Rural Women Post-Invasive Coronary Interventions

2020 ◽  
Vol 20 (2) ◽  
pp. 78-107
Author(s):  
Modjadji Mosima Choshi ◽  
Anne G Rosenfeld ◽  
Mary S Koithan
Keyword(s):  
Coronary Artery Disease ◽  
Health Care ◽  
Coronary Artery ◽  
Health Care Providers ◽  
Rural Women ◽  
Self Care ◽  
Care Providers ◽  
Coronary Interventions ◽  
Artery Disease ◽  
Care Behavior

Purpose: Self-care is an essential component of secondary prevention of coronary artery disease (CAD) for rural women after undergoing invasive coronary interventions (ICI). The purpose of the study was to describe self-care behavior experiences of rural women with CAD post-ICI. The specific aims were: to identify and describe self-care behaviors initiated by rural women post-ICI; and to identify and describe barriers to and facilitators of self-care behavior adoption. The language used to describe self-care can be different between health care providers, who are guided by the American Heart Association (AHA), and rural women whose descriptions are based on their life experiences. Methods: Qualitative descriptive methods were used to purposefully sample women (N=10) from two rural Arizona counties. Data were collected using semi-structured face-to-face interviews, lasting approximately 25minutes. Atlas.ti Mac Version 1.5.2 (462) was used for data analysis. Findings: Aim 1: Healthy diet was the most common self-care behavior described by rural women. When describing self-care behaviors, rural women used a different language, which was in alignment with AHA guidelines for self-care behaviors. Aim 2: Themes identified and described for barriers were: residential environment, health and physical ailments, family conditions, and personal characteristics; and for facilitators were relationships, available resources, and personal outcomes. Conclusions: Regardless of poor health-promoting environment, such as unavailability of fresh food stores and access to exercise opportunities rural women took advantage of what they had to keep healthy. They performed self-care behaviors that they described as good for their health and made them happy without associating them the expected self-care behaviors to prevent reoccurrences and complications post-ICI. Rural health care providers must recognize these challenges, acknowledge the positive assets wihin rural women, and incorporate them into the programs for self-care behavior modification strategies. Keywords: Self-care, rural women, coronary artery disease, invasive coronary interventions DOI:  http://doi.org/10.14574/ojrnhc.v20i2.629  

scholarly journals Lived Experiences of Patients with Coronary Artery Disease: A Qualitative Study from a Cardiac Center of a Regional Hospital in Mauritius

2021 ◽  
Vol 16 ◽  
pp. 11
Author(s):  
Ananya Shukla ◽  
Satvik Jain ◽  
Nihal Mohammed ◽  
Tasneem Hussain ◽  
Indrajit Banerjee
Keyword(s):  
Coronary Artery Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Qualitative Study ◽  
Qualitative Interviews ◽  
Improve Patient Care ◽  
Cardiac Patients ◽  
Atherosclerotic Cardiovascular Disease ◽  
Lifestyle Modifications ◽  
Artery Disease

Objectives: Coronary artery disease (CAD), also known as ischemic heart disease or atherosclerotic cardiovascular disease (CVD), is one of the major causes of morbidity and mortality globally and has contributed to about 80% of sudden deaths. There have been advancements in the diagnosis and treatment of CAD, some of which are still going on to improve patient care, however, there is a dearth of information regarding the various challenges the patients go through after being diagnosed with CAD and so a qualitative study was conducted on cardiac patients in Mauritius to shine a light on the various aspects of life affected by CAD. This is the first qualitative study conducted on cardiac patients in Mauritius. Material and Methods: A phenomenological qualitative study was performed on 12 patients who were diagnosed with CAD, at the Cardiac Unit of Victoria Hospital, Mauritius. By the use of NVivo 12 (Windows) Plus software, after it was transcribed, codes/nodes and themes were generated. Results: Twenty-five different codes were inferred from the study done and from the respective codes, eight main themes were established. The main themes drawn from the study were as follows: Emotional factors, risk factors, optimistic factors, support, awareness of your health, consequences, lifestyle modifications, and the healthcare system. Conclusion: An event of CAD is an experience with multifaceted influences on innumerable aspects of the patient’s life. The study illuminated the immense sufferings and emotional bearings of those patients who were living with heart disease. They expressed their overbearing, insecurities, and a loss of control over various aspects of their lives. This study provided various thought-provoking themes that emerged after transcribing the qualitative interviews. It also highlighted the various challenges faced by patients and how the beliefs of patients with CAD were vital to sustaining them. Family support is a vital aspect in keeping the patient both motivated to follow their treatment and emotionally grounded.

Dynamics of course and adherence to treatment in conservative and surgical treatment of chronic coronary artery disease connected with hypertension

2019 ◽  
Vol 1 (3) ◽  
pp. 34-38
Author(s):  
D. A. Yakhontov ◽  
A. V. Zvonkova
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Comparison Group ◽  
Myocardial Infarct ◽  
Main Group ◽  
Functional Class ◽  
Adherence To Treatment ◽  
Chronic Coronary Artery Disease ◽  
Optimal Drug ◽  
Artery Disease

The purpose of this study was to compare the clinical status, miocardial morphofunctional parameters and adherence to treatment on the background of optimal drug therapy (ODT, including agents improve the prognosis and percutaneous coronary intervention (PCf) in combination with ODT in patients with stable coronary artery disease in combination with hypertension grade 1-2 during prospective observation. The study included 125 men aged 50-75 years. The main group (PCf with ODT) included 78 patients aged 61.5 ± 8.5 years; the comparison group (ODT includes 47 patients aged 63.5 ± 7.1 years. Patients did not significantly differ in age and frequency of major cardiovascular risk factors. Both groups’ patients also did not significantly differ in the angina functional class, of ischemic and hypertensive history duration, myocardial infarct frequency and HF functional class. After a year of observation, there were no significant differences in myocardium morphometric and functional parameters in both groups patients against the background of the treatment. 64 (51.2 %) patients, 42 in the main group and 22 in the comparison group, remained fully adherent to treatment. Greatest commitment found in patients younger than 60 years. The main reason of low adherence was a lack of understanding of the need medication taking with good health and normal blood pressure (BP)

scholarly journals Integrated Framework for Prognosis of Coronary Artery Disease

2018 ◽  
Vol 7 (2.32) ◽  
pp. 1
Author(s):  
D Rajeswara Rao ◽  
J V.R Murthy
Keyword(s):  
Coronary Artery Disease ◽  
Decision Support ◽  
Coronary Artery ◽  
Decision Support Systems ◽  
Support Systems ◽  
Support Vector ◽  
Multi Layer Perceptron ◽  
The World ◽  
Artery Disease ◽  
Primary Focus

Coronary Artery Disease, commonly known as Heart Disease, has resulted in casualties all over the world. Currently, diagnosis of these  conditions mainly relies on experience of doctors and partly on few decision support systems. Most decision support systems built for  this domain have limitations. The major limitation is requirement of huge quantity of historical conditions data and appropriate related diagnosis labels. Proposed framework addresses this limitation by providing diagnosis  comparable with existing systems while only taking available data in absence of labels.  This is achieved by forming a novel framework using Self Organizing Networks and  Learning Vector Quantization. Here, competitive learning paradigm of soft  computing is primary focus. Proposed framework is compared with four well established  existing systems namely Support Vector Machine, Decision Tree, Random Forest and Multi Layer Perceptron. After comparison and analysis it has been proved that proposed framework gives comparable results even without supplying labeled data.In future this framework can be extended to variegated applications in various domains.  

scholarly journals Self-care interventions in patients with coronary artery disease: room for improvement

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Westland ◽  
T Jaarsma ◽  
B Riegel ◽  
P Iovino ◽  
O Henry Osokpo ◽  
...  
Keyword(s):  
Physical Activity ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Care Management ◽  
Behavioural Change ◽  
Self Care ◽  
Activity Level ◽  
Public Institution ◽  
Funding Source ◽  
Artery Disease

Abstract   After a coronary artery event it is vital that patients perform self-care Self-care can be defined broadly as a process of maintaining health through treatment adherence and health-promoting practices (self-care maintenance), behavior and condition monitoring (self-care monitoring), and managing signs and symptoms when they occur (self-care management). For patients with coronary artery disease (CAD) essential self-care activities include adherence to medication, risk-factor management, symptom monitoring and preventive behavior. To advance the field of self-care in CAD patients, it is important to understand which self-care elements are currently addressed in interventions studies. The purpose of this study was to describe which behaviors are emphasized in self-care interventions for patients with CAD. Methods We conducted a systematic review of self-care interventions in chronic diseases. Four databases were search for randomized controlled trials with allocation to an intervention or to usual care or another intervention in adults with nine major symptomatic chronic conditions, one of which was coronary artery disease. Between 2008 and 2019 there were 9309 potential articles addressing self-care in chronic disease. After duplicates were removed and titles and abstracts were reviewed, 166 full-text articles on CAD studies evaluating a self-care intervention were assessed for eligibility and 15 studies remained after further assessment. Results Almost all studies (80%) in CAD patients included all three components of self-care (self-care maintenance, monitoring and management) in their interventions. Self-care maintenance behaviors addressed in these studies were mainly related to physical activity (73%) diet (60%) and medication management (33%) Another 40% included a psychosocial component, but only 4 studies (26%) were specially targeted at smoking behavior. With regard to self-care monitoring, most (60%) included monitoring of their physical activity level and 26% monitoring of symptoms. Self-care management behaviours were addressed rarely, but when addressed, focused on adapting activity level (60%), adapting diet (27%), medication changes (20%) and stress reduction (20%). Goal setting (60%), problem solving (40%) and feedback (33%) were the behavioural change techniques that were used most often to promote self-care. Only 1 study mentioned the use of social support. One study used reminders. Conclusions Most interventions that are tested to improve outcomes in patients with CAD address self-care maintenance, monitoring, management. The behavioural change techniques used are limited. There is a large variation in which behaviours are emphasized in research studies and the focus is primarily on changing traditional lifestyle factors, but not all life-style factors are addressed adequately in the interventions. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Australian Catholic University

Use of combination pills with acetylsalicylic acid and clopidogrel in coronary artery disease. Efficacy and assessment of adherence to treatment: Kobra Study

2021 ◽  
Vol 23 (1) ◽  
pp. 61-69
Author(s):  
Nikita V. Lomakin ◽  
◽  
Liudmila I. Buryachkovskaya ◽  
Anastasya A. Senichkina ◽  
Alexander B. Sumarokov ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Salicylic Acid ◽  
Coronary Artery ◽  
Acetylsalicylic Acid ◽  
Antiplatelet Therapy ◽  
Fixed Combination ◽  
Adherence To Treatment ◽  
Coronary Syndrome ◽  
Artery Disease

Aim. Assessment of the efficacy and adherence to treatment with acetylsalicylic acid (ASA) and clopidogrel combination drug compared to separate administration of the drugs in patients with acute coronary syndrome and patients with chronic coronary syndrome after coronary stent implantation. Materials and methods. The study included 100 patients randomized to receive either original clopidogrel (Plavix® Sanofi) only or original ASA (Aspirin® Cardio Bayer) only or the generic fixed drug combination (Plagril® A Dr. Reddy's Laboratories Ltd.). Over the first 7–10 days after the index event, all patients were treated with a separate drug in the hospital, then received double antiplatelet therapy with appropriate drugs on an outpatient basis for 4 months, and purchased the drugs on their own for the last 2 months of follow-up. Monitoring the efficacy of therapy and patient adherence to treatment was carried out according to the clinic data, platelet aggregation indicators and blood thromboxane B2 (TXB2), salicylic acid and clopidogrel metabolite (carboxylic acid) levels on the 7th day after disease onset and after 8 and 16 weeks of treatment. Results. Most of the patients were elderly (mean age 68.3±10.6 years), of them 35% were women. After 8 and 16 weeks of treatment in hospital, platelet aggregation indicators did not differ between patients taking separate drugs or a fixed combination. The generic Plagril® A inhibited the aggregation response similarly to the original drugs. At moment of randomization, baseline blood TXB2, salicylic acid and the carboxyl metabolite of clopidogrel levels were comparable in both groups of patients (p>0.05). After 8 weeks of therapy, patients taking Plagril® A had significantly lower TXB2 levels compared with the separate administration of Plavix and Aspirin Cardio: 0.1±0.05 ng/ml vs 0.2±0.23 ng/ml, respectively (p<0.001). After 16 weeks, TXB2 levels reached 0.28±0.56 ng/ml vs 0.43±0.48 ng/ml, respectively (p=0.006). There were no differences in blood salicylic acid and clopidogrel carboxyl metabolite blood levels between the groups of patients during the entire study period. Adherence to antiplatelet therapy during inpatient period of treatment was 100%. In the first 8 weeks, it decreased to 74.5%, and after 16 weeks – to 71.5%. When taking the drugs separately, missing rate was higher in ASA group: 21.2% vs 5% in clopidogrel group. Conclusion. Plagril® A is bioequivalent and as effective as the original ASA and clopidogrel taken separately, in terms of the effect on platelet activity and blood clopidogrel metabolite levels. The adherence to a fixed combination of clopidogrel and ASA in patients with acute coronary syndrome and patients with chronic coronary syndrome is significantly higher than when these drugs are taken separately, both at the stages of free treatment and when purchasing drugs on their own. Keywords: antiplatelet therapy, acetylsalicylic acid, clopidogrel, adherence to secondary prevention, coronary heart disease For citation: Lomakin NV, Buryachkovskaya LI, Senichkina AA, Sumarokov AB, Docenko UV, Kazey VI. Use of combination pills with acetylsalicylic acid and clopidogrel in coronary artery disease. Efficacy and assessment of adherence to treatment: Kobra Study. Consilium Medicum. 2021; 23 (1): 61–69. DOI: 10.26442/20751753.2021.1.200780

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