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Psychol Health. 2017 Oct;32(10):1176-1194. doi: 10.1080/08870446.2016.1260724. Epub 2016 Dec 20.

Identifying determinants of medication adherence following myocardial infarction using the Theoretical Domains Framework and the Health Action Process Approach.

Author information

1
a Clinical Epidemiology , Ottawa Hospital Research Institute, University of Ottawa , Ottawa , Canada.
2
b School of Epidemiology, Public Health and Preventive Medicine , University of Ottawa , Ottawa , Canada.
3
c Population Health Research Institute , McMaster University , Hamilton , Canada.
4
d Department of Medicine , University of Ottawa , Ottawa , Canada.
5
e Department of Family and Emergency Medicine , Laval University , Quebec City , Canada.
6
f Research Centre of the Centre Hospitalier Universitaire de Québec , Quebec City , Canada.
7
g Women's College Hospital , Toronto , Canada.
8
h Department of Family and Community Medicine , University of Toronto , Toronto , Canada.

Abstract

BACKGROUND:

Despite evidence-based recommendations, adherence with secondary prevention medications post-myocardial infarction (MI) remains low. Taking medication requires behaviour change, and using behavioural theories to identify what factors determine adherence could help to develop novel adherence interventions.

OBJECTIVE:

Compare the utility of different behaviour theory-based approaches for identifying modifiable determinants of medication adherence post-MI that could be targeted by interventions.

METHODS:

Two studies were conducted with patients 0-2, 3-12, 13-24 or 25-36 weeks post-MI. Study 1: 24 patients were interviewed about barriers and facilitators to medication adherence. Interviews were conducted and coded using the Theoretical Domains Framework. Study 2: 201 patients answered a telephone questionnaire assessing Health Action Process Approach constructs to predict intention and medication adherence (MMAS-8).

RESULTS:

Study 1: domains identified: Beliefs about Consequences, Memory/Attention/Decision Processes, Behavioural Regulation, Social Influences and Social Identity. Study 2: 64, 59, 42 and 58% reported high adherence at 0-2, 3-12, 13-24 and 25-36 weeks. Social Support and Action Planning predicted adherence at all time points, though the relationship between Action Planning and adherence decreased over time.

CONCLUSIONS:

Using two behaviour theory-based approaches provided complimentary findings and identified modifiable factors that could be targeted to help translate Intention into action to improve medication adherence post-MI.

KEYWORDS:

Health Action Process Approach; Theoretical Domains Framework; medication adherence; myocardial infarction

PMID:
27997220
DOI:
10.1080/08870446.2016.1260724
[Indexed for MEDLINE]

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