GP-delivered secondary prevention cardiovascular disease programme; early predictors of likelihood of patient non-adherence.
BACKGROUND
The aim of this study was to determine how routinely recorded data could predict early the likelihood of patient non-adherence to a primary care-delivered secondary prevention programme for established coronary heart disease (CHD), with patients with CHD (10,851) invited to attend four times per year.


METHODS
Non-adherence was defined as attending no more than three GP visits ever. The study sample was selected to allow a possible two-year recorded follow-up period in which patients could take up invitations. Administrative recordings of visit dates and intervals between visits, baseline results of key parameters and early changes were examined using logistic regression to determine independent predictors of non-adherence.


RESULTS
Longer interval between early visits, no family history of CHD, smoking and being outside target for exercise at baseline were independently associated with non-adherence.


CONCLUSIONS
Early identification by GPs of those who fail to attend on time or who defer appointments, in addition to persistence of lifestyle factors unchanged by a prior serious cardiac event should serve as a warning sign that targeted interventions to maintain adherence in primary care-delivered secondary prevention programmes are necessary.
Fitzpatrick
Patricia
P
Lonergan
Moira
M
Collins
Claire
C
Daly
Leslie
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001071:Appointments and Schedules; D003327:Coronary Disease / Q000517:prevention & control* / Q000628:therapy*; D015444:Exercise; D005260:Female; D058005:General Practitioners; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011320:Primary Health Care; D012307:Risk Factors; D055502:Secondary Prevention / Q000706:statistics & numerical data*; D012907:Smoking; D013997:Time Factors; D017211:Treatment Failure