Adherence to a prophylactic medication regimen in patients with symptomatic versus asymptomatic ischemic heart disease

Robert M. Carney, Kenneth E. Freedland, Seth A. Eisen, Michael W. Rich, Judith A. Skala, Allan S Jaffe

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Although angina pectoris is the most common symptom of coronary artery disease, some patients do not experience angina during ischemic episodes. The effects of asymptomatic (silent) heart disease on patient self-management have rarely been studied. Studies of other patient populations with asymptomatic illnesses indicate that patients with silent myocardial ischemia might adhere less well to a prophylactic medication regimen than would those with symptomatic ischemia. Depression, a state associated with poor adherence to medical regimens, is more common among patients with symptomatic ischemia. For prevention of thromboembolic events, 37 patients with documented ischemic heart disease who denied having anginal symptoms and 28 patients who reported almost daily symptoms were given a 3-week supply of low-dose aspirin packaged in an unobtrusive electronic adherence monitor. All other medications were provided in standard pill bottles. The symptomatic patients removed their prescribed aspirin on 62.4% of the days; the patients with silent ischemia took their medication on 77.3% of the days. Possible explanations for these results, their clinical implications, and directions for future research are discussed.

Original languageEnglish (US)
Pages (from-to)35-39
Number of pages5
JournalBehavioral Medicine
Volume24
Issue number1
StatePublished - Mar 1998
Externally publishedYes

Fingerprint

Myocardial Ischemia
Ischemia
Aspirin
Angina Pectoris
Self Care
Coronary Artery Disease
Heart Diseases
Population

Keywords

  • Asymptomatic myocardial ischemia
  • Medication adherence

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Adherence to a prophylactic medication regimen in patients with symptomatic versus asymptomatic ischemic heart disease. / Carney, Robert M.; Freedland, Kenneth E.; Eisen, Seth A.; Rich, Michael W.; Skala, Judith A.; Jaffe, Allan S.

In: Behavioral Medicine, Vol. 24, No. 1, 03.1998, p. 35-39.

Research output: Contribution to journalArticle

Carney, Robert M. ; Freedland, Kenneth E. ; Eisen, Seth A. ; Rich, Michael W. ; Skala, Judith A. ; Jaffe, Allan S. / Adherence to a prophylactic medication regimen in patients with symptomatic versus asymptomatic ischemic heart disease. In: Behavioral Medicine. 1998 ; Vol. 24, No. 1. pp. 35-39.
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