title: Intentional and unintentional non-adherence to medications following an acute coronary syndrome: a longitudinal study.
abstract: OBJECTIVE
  Non-adherence to medication is common among coronary heart disease patients. Non-adherence to medication may be either intentional or unintentional. In this analysis we provide estimates of intentional and unintentional non-adherence in the year following an acute coronary syndrome (ACS).
  
  
  METHODS
  In this descriptive prospective observational study of patients with confirmed ACS medication adherence measures were derived from responses to the Medication Adherence Report Scale at approximately 2 weeks (n=223), 6 months (n=139) and 12 months (n=136) following discharge from acute treatment for ACS.
  
  
  RESULTS
  Total medication non-adherence was 20%, 54% and 53% at each of these time points respectively. The corresponding figures for intentional non-adherence were 8%, 15% and 15% and 15%, 52% and 53% for unintentional non-adherence. There were significant increases in the levels of medication non-adherence between the immediate discharge period (2 weeks) and 6 months that appeared to stabilize between 6 and 12 months after acute treatment for ACS.
  
  
  CONCLUSIONS
  Unintentional non-adherence to medications may be the primary form of non-adherence in the year following ACS. Interventions delivered early in the post-discharge period may prevent the relatively high levels of non-adherence that appear to become established by 6 months following an ACS.
authors.affiliation: School of Psychology, National University of Ireland Galway, Ireland. Electronic address: gerry.molloy@nuigalway.ie.
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Molloy
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Bern, Switzerland.
authors.forename: Nadine
authors.initials: N
authors.lastname: Messerli-Bürgy
authors.affiliation: Department of Epidemiology & Public Health, UCL, United Kingdom.
authors.forename: Gemma
authors.initials: G
authors.lastname: Hutton
authors.affiliation: Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Wikman
authors.affiliation: Division of Population Health Sciences and Education, St. George's University of London, United Kingdom.
authors.forename: Linda
authors.initials: L
authors.lastname: Perkins-Porras
authors.affiliation: Department of Epidemiology & Public Health, UCL, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Steptoe
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000523:psychology*; D000328:Adult; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000523:psychology*; D003327:Coronary Disease / Q000188:drug therapy / Q000523:psychology; D005260:Female; D006801:Humans; D033182:Intention; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D010351:Patient Discharge; D011446:Prospective Studies
chemical_list: D002317:Cardiovascular Agents
keywords: Acute coronary syndrome; Adherence; Intention; Psychological
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