title: Patients' adherence to secondary prevention pharmacotherapy after acute coronary syndromes.
abstract: BACKGROUND
  Secondary prevention pharmacotherapy improves outcomes after acute coronary syndrome (ACS). However, poor medication adherence is common, and various factors play a role in adherence.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate patients' level of adherence to evidence-based therapies at an average of 6 months after discharge for acs and to identify factors associated with self-reported non-adherence.
  
  
  METHODS
  This prospective study was conducted in the outpatient cardiac clinics of Hospital Pulau Pinang, located in Penang Island, a northern state in Malaysia.
  
  
  METHODS
  A random sample of ACS patients (n = 190) who had been discharged on a regimen of secondary preventive medications were included in this study. Six months after discharge and during their scheduled follow-up appointments to cardiac clinics, patients were interviewed using the translated eight-item Morisky Medication Adherence Scale.
  
  
  METHODS
  self-reported patients' adherence to medication.
  
  
  RESULTS
  Six months following their hospital discharge, only 35 patients (18.4 %) reported high adherence. Medium adherence was reported in majority of patients (51.1 %). Low adherence was reported in 58 patients (30.5 %). Forgetfulness was the most frequently reported reason for patients' non-adherence to their medications (23.2 %). Furthermore, this study identified 5 factors-namely age, employment status, ACS subtypes, number of comorbidities, and number of prescription medications per day-that may influence Patients' level of adherence to the prescribed regimens.
  
  
  CONCLUSIONS
  Our findings revealed a problem of non-adherence to secondary prevention medications among patients with ACS in Malaysia. Furthermore, this study demonstrates that older patients, unemployed patients, patients with more comorbid conditions, and those receiving multiple medications are less likely to adhere to their prescribed medications 6 months after hospital discharge.
authors.affiliation: Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Pulau Pinang, Malaysia. dryamankassab@yahoo.com
authors.forename: Yaman
authors.initials: Y
authors.lastname: Kassab
authors.forename: Yahaya
authors.initials: Y
authors.lastname: Hassan
authors.forename: Noorizan
authors.initials: N
authors.lastname: Abd Aziz
authors.forename: Omar
authors.initials: O
authors.lastname: Ismail
authors.forename: Hadeer
authors.initials: H
authors.lastname: AbdulRazzaq
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000517:prevention & control; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D004651:Employment; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008296:Malaysia; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D011446:Prospective Studies; D055502:Secondary Prevention / Q000379:methods*