Medication adherence and hospitalizations in older patients with coronary heart disease in Vietnam

Abstract

Aims

This study aimed to assess medication adherence among older people with coronary heart disease and its relationship with hospitalizations.

Methods

This is a prospective cohort study conducted at the outpatient clinics of a major hospital in Vietnam from November 2022 to June 2023. Consecutive older patients with coronary heart disease were recruited and followed for 6 months. Medication adherence was defined using the five-item Medication Adherence Report Scale (MARS-5). Multivariable logistic regression models were applied to examine the impact of medication adherence on hospitalization due to cardiovascular disease (CVD) and all-cause hospitalization.

Results

There were 643 participants, mean age 73 ± 8 years, 74.3% were male. Overall, 76.4% (491/643) were classified as ‘adherent’. Over 6 months follow-up, 23.3% of the participants were admitted to hospital and of these hospitalizations, 9.2% were due to CVD. The CVD-related hospitalization rate was significantly higher in the non-adherent group compared to the adherent group (13.8% vs. 7.7%, P = 0.023, respectively). In logistic regression models, medication adherence was associated with significantly reduced odds of CVD-related hospitalization (adjusted odds ratio [OR] 0.48, 95% confidence interval [CI] 0.27–0.86). Medication adherence was also associated with a trend of reduced all-cause hospitalization (adjusted OR 0.75, 95% CI 0.49–1.15).

Conclusions

This study showed a positive relationship between medication adherence and reduced risk of CVD-related hospitalization in older people with coronary heart disease. Healthcare providers should consider incorporating adherence assessment into the long-term care for older patients with coronary heart disease.