The Effect of Assessing Barriers and Self-efficacy Enhancement Program on Medication Adherence

Acute myocardial infarction is leading cause of death in developed country. After receiving acute treatment, post- acute myocardial infarction patients must adhere to specific medication regimens because they play a crucial role in treating post- acute myocardial infarction and maintaining health. Medication adherence defines as post-AMI patients continuing to take medication according to post- acute myocardial infarction patients agreed recommendations from a health care provider during they are in treatment after discharge. Effective medication adherence reduces cardiac events, morbidity, mortality, rehospitalization rates, healthcare costs, and enhances well-being among patients with acute myocardial infarction. Studies have reported that adherence to medications after hospital discharge for myocardial infarction is poor with about 12% to 20% of patients discontinue their medications six months after discharge.

Purpose: This study  aimed to examine the effect of self-efficacy enhancement program on medication adherence in post- acute myocardial infarction patients. 

Methods: A total 44 patient with post-acute myocardial infarction were recruited from the in-patient department, Police General Hospital. The participants were random assigned into control group and experimental group. The control group received conventional care while the experimental group attended a four-week self-efficacy enhancement program, which included motivation, skill practice, and monitoring skills. The mean self-efficacy score between groups was assessed. The pill count was used to measure medication adherence. Correlations between self-efficacy and medication adherence were examined. Data were analyzed using descriptive statistic, Pearson’s correlation, and t-test. 

Results: The mean score on medication adherence of the experiment group who attended the self-efficacy enhancement program was significantly greater than the control group (t = -2.77; df= 21; p = 0.01). The mean score of self-efficacy between the experimental and control group were 35.73 (SD= 4.11) and 35.41 (SD= 3.78). The correlations between self-efficacy and medication adherence was significantly (r=1.00, p =0.00).

Conclusion: The effectiveness of self-efficacy enhancement program was effective in improving medication adherence in Thai post-acute myocardial infarction.