Fernando Maia Coutinho et al. Talles L. Pereira Nogueira Dilma do Socorro Moraes de Souza Lucianna Serfaty de Holanda … Vitor Bruno Teixeira de Holanda Michele N. Assad Rafael M. Coutinho Ana Flávia Oliveira de Souza Márcio César Ribeiro Marvão Thiago da Silva Paulo
Abstract
Background:
Patients with coronary artery disease (CAD) are categorized by cardiovascular risk depending on associated risk factors and events, requiring more rigorous treatment goals.
Objective:
To investigate treatment adherence, using the Morisky–Green test, and achievement of metabolic goals at a tertiary public hospital in Belém, Pará, Brazil.
Methods:
This observational, cross-sectional, and analytical study was conducted with a sample of 106 patients with CAD at very high cardiovascular risk, treated in the outpatient clinic of a tertiary care hospital. The following data were collected over a 4-month period: demographic information, medication adherence (Morisky–Green test), modifiable risk factors, and laboratory parameters (lipids, blood glucose, blood pressure, heart rate, and abdominal circumference). Associations were assessed using chi-square test or G test, and correlations were analyzed using Spearman’s test, adopting a significance level of 5% (p < 0.05).
Results:
Treatment adherence analysis showed an adherence rate of 16.0%. Low-density lipoprotein (LDL) -cholesterol levels were above the target of 50 mg/dL in 72.6% of patients, and normal blood glucose was achieved in 75.5%. Education level was the only epidemiological variable associated with therapeutic non-adherence (p = 0.0130). Regarding financial aspects, only 9.4% reported persistent difficulty in purchasing medications; among those reporting difficulty, high-potency statins were the most frequently cited (58.6%).
Conclusions:
Education level was shown to be a determining factor in understanding treatment, impacting adherence. Laboratory tests revealed significant deficiencies in lipid control, reinforcing the need for clinical optimization. Difficulties in accessing statins and low medication adherence underscore the importance of educational interventions and multidisciplinary approaches for better management of CAD.