Frequency and Predictors of Non-Compliance to Aspirin Therapy in Post Myocardial Infarction Patients

BACKGROUND: Aspirin non-adherence or discontinuation is associated with an almost three-fold increase in risk of major adverse cardiac events. Compliance, commonly known as adherence, has been a major health care issue. Some studies have reported non-adherence rates to aspirin as high as fifty percent. The main objective of this study was to determine the frequency and predictors of non-compliance to aspirin in post myocardial infarction patients.

METHODS: This cross sectional study was conducted over a period of 3 months from May 2015 to July 2015 at Civil Hospital, Karachi. All patients visiting Cardiology out-patient department (OPD) with previously diagnosed myocardial infarction were included in the study. Patients who were not prescribed aspirin or those with contraindication to aspirin therapy such as hemophiliacs and peptic ulcer disease patients, and those with memory problems were excluded from the study. A pre-coded questionnaire was presented to the selected sample of 456 patients. Compliance was assessed through self-report. Chi square test was used as the primary statistical test.

RESULTS: Out of 456 patients, 39% (n=178) were non-compliant to aspirin therapy. The most common reported cause for non-compliance was the failure to remember taking the drug reported by 40.7% (n=72) of the people. The second most common cause was the lack of awareness of the importance of the drug and the possible side effects of not taking it 31.4% (n =56).

CONCLUSION: It can be concluded that non-compliance to aspirin is a major problem present in Pakistan. With the number of cardiovascular deaths increasing around the globe and in Pakistan, it is vital that non-compliance to aspirin should be taken as a serious issue.