Abstract

Background: Adherence to treatment is a cornerstone regarding progression of coronary heart disease, which is the most common cause of death among females. Coronary heart disease in women has special characteristics: the conventional risk factors are more harmful to females than males, accumulation of risk factors is common, and the female gender is related to nontraditional risk factors such as gestational diabetes and preeclampsia. Additionally, worse outcomes, higher incidence of death, and complications after percutaneous coronary intervention have been reported more often among females than among male patients.

Objective: To test a model of adherence to treatment among female patients with coronary heart disease after a percutaneous coronary intervention.

Methods: A cross-sectional, descriptive and explanatory survey was conducted in 2013 with 416 CHD patients, of which 102 female patients were included in this sub-study. Self-reported instruments were used to assess female patient adherence to treatment. Data were analyzed using descriptive statistics and a structural equation model.

Results: Motivation was the strongest predictor for female patients’ perceived adherence to treatment. Informational support, physician support, perceived health, and physical activity were indirectly, but significantly, associated with perceived adherence to treatment via motivation. Furthermore, physical activity was positively associated with perceived health, while anxiety and depression were negatively associated with it.

Conclusions: Secondary prevention programs and patient education have to take into account individual or unique differences. It is important to pay attention to issues that are known to contribute to motivation rather than to reply on education alone to improve adherence.