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.