• THENMOZHI P. Associate Professor, Department of Medical Surgical Nursing, Saveetha College of Nursing, SIMATS, Chennai, India
  • PRIYA T. B. Sc. (N) IV Year, Saveetha College of Nursing, SIMATS, Chennai, India


Objective: Compliance in following healthy diet, physical activity schedule, cessation of smoking and alcohol, medication adherence and regular follow up is very essential component in the management of patients with cardiovascular disease to prevent reoccurrence and reduce mortality. Hence the study was conducted with the aim to assess the factors contributing for noncompliance of follow-up care among post cardiac patients.

Methods: Cross-sectional research design was employed with 50 samples who matched the inclusion criteria were selected by convenience sampling technique. Demographic variables data were collected by using structured questionnaire followed by assessed the factors contributing for noncompliance using checklist.

Results: The findings of the current study revealed that all physical, psychological, economical, social and spiritual factors were highly influenced the noncompliance. Of these, the highest percentage 80% reported lack of accessibility as well financial support and around 70% percentage reported side effects of medication and low health literacy.

Conclusion: Health care providers need to be focussed on interventional strategies especially health education in discharge plan to ensure that these patients adhere to follow up including medication adherence, following physical activity plan, dietary modification, lifestyle changes and regular follow up visit to prevent readmission and lead a successful life.

Keywords: Adherence, Cardiac patients compliance, Follow up care, Noncompliance, Side effects of medication


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1. https://www.who.int/cardiovascular_diseases/en/ [Last accessed on 10 Jun 2019]
2. https://www.who.int/cardiovascular_diseases/world-hypertension-day-2019/en/ [Last accessed on 10 Jun 2019]
3. Shay LE. A concept analysis: adherence and weight loss. Nurs Forum 2008;43:42-52.
4. Lehane E, McCarthy G. An examination of the intentional and unintentional aspects of medication non-adherence in patients diagnosed with hypertension. J Clin Nurs 2007;4:698-706.
5. Ulfvarson J, Bardage C. Adherence to drug treatment in association with how the patient perceives care and information on drug. J Clin Nurs 2007;2:141-8.
6. Chowdhury R, Khan H, Heydon E, Shroufi A, Fahimi S, Moore C, et al. Adherence to cardiovascular therapy: a meta-analysis of prevalence and clinical consequences. Eur Heart J 2013;34:2940–8.
7. Baroletti S, Dell’Orfano H. Medication adherence in cardiovascular disease. Circulation 2010;121:1455–8.
8. Kulkarni SP, Alexander KP, Lytle B, Heiss G, Peterson ED. Long-term adherence with cardiovascular drug regimens. Am Heart J 2006;151:185–91.
9. Bowry AD, Shrank WH, Lee JL, Stedman M, Choudhry NK. A systematic review of adherence to cardiovascular medications in resource-limited settings. J Gen Intern Med 2011;26:1479–91.
10. Kyngas H, Rissanen M. Support as a crucial predictor of good compliance of adolescents with a chronic disease. J Clin Nurs 2001;10:767–74.
11. Kyngas H, Lahdenpera T. Compliance of patients with hypertension and associated factors. J Ad Nurs 1999;29:832–9.
12. Apter AJ, Reisine ST, Affleck G. Adherence with twice-daily dosing of inhaled steroids. Socioeconomic and health-belief differences. Am J Respir Crit Care Med 1998;157:1810–7.
13. Bartlett EE, Grayson M, Barker R. The effects of physician communications skills on patient satisfaction; recall, and adherence. J Chronic Dis 1984;37:755–64.
14. Lim TO, Ngah BA, Rahman RA. The mentakab hypertension study project Part V–Drug compliance in hypertensive patients. Singapore Med J 1992;33:63–6.
15. Vlasnik JJ, Aliotta SL, DeLor B. Medication adherence: factors influencing compliance with prescribed medication plans. Case Manager 2005;16:47–51.
16. Lorenc L, Branthwaite A. Are older adults less compliant with prescribed medication than younger adults? Br J Clin Psychol 1993;32:485–92.
17. Cummings KM, Kirscht JP, Binder LR. Determinants of drug treatment maintenance among hypertensive persons in inner city Detroit. Public Health Rep 1982;97:99–106.
18. Kelloway JS, Wyatt RA, Adlis SA. Comparison of patients’ compliance with prescribed oral and inhaled asthma medications. Arch Intern Med 1994;154:1349–52.
19. Okuno J, Yanagi H, Tomura S. Is cognitive impairment a risk factor for poor compliance among Japanese elderly in the community? Eur J Clin Pharmacol 2001;57:589–94.
20. Hernandez Ronquillo L, Tellez Zenteno JF, Garduno Espinosa J. Factors associated with therapy noncompliance in type-2 diabetes patients. Salud Publica Mex 2003;45:191–7.
21. Ponnusankar S, Surulivelrajan M, Anandamoorthy N. Assessment of impact of medication counseling on patients’ medication knowledge and compliance in an outpatient clinic in South India. Patient Educ Couns 2004;54:55–60.
22. Wai CT, Wong ML, Ng S. Utility of the health belief model in predicting compliance of screening in patients with chronic hepatitis B. Aliment Pharmacol Ther 2005;21:1255–62.
23. Ellis JJ, Erickson SR, Stevenson JG. Suboptimal statin adherence and discontinuation in primary and secondary prevention populations. J Gen Intern Med 2004;19:638–45.
24. Ponnusankar S, Surulivelrajan M, Anandamoorthy N. Assessment of impact of medication counseling on patients’ medication knowledge and compliance in an outpatient clinic in South India. Patient Educ Couns 2004;54:55–60.
25. Oosterom Calo. Determinants of adherence to heart failure medication. Heart Fail Rev 2013;18:409-27.
26. DiMatteo MR. Patient adherence to pharmacotherapy: the importance of effective communication. Formulary 1995;30:596–8, 601–2, 605.
27. Sabate E. editor. Adherence to long-term therapies: evidence for action. Geneva: World Health Organization; 2003.
28. Jing Jin, Grant Edward Sklar, Vernon Min Sen Oh, Shu Chuen Li. Factors affecting therapeutic compliance: a review from the patient’s perspective. Ther Clin Risk Manag 2008;4:269–86.
29. Abbas Heydari. Relationship between awareness of disease and adherence to therapeutic regimen among cardiac patients. Int J Community Based Nurs Midwifery 2015;3:23-30.
30. Gouranga Santra. Assessment of adherence of cardiovascular medicines in rural population. Indian J Pharmacol 2015;47:600-4.
31. Atkinson RC, Branum K. Home-based disease management in congestive heart failure. Home Health Care Manag Prac 2001;13:106-13.
32. Brooke Aggarwal. Factors associated with medication adherence among heart failure patients and their caregivers. HHS Public Access 2015;5:22-7.
33. Van Der Wal MH. Unraveling the mechanisms for heart failure patients, beliefs about compliance. Heart-lung 2007;36:253-6.
34. Iihara N, Tsukamoto T, Morita S. Beliefs of chronically ill Japanese patients that lead to intentional non-adherence to medication. J Clin Pharm Ther 2004;29:417–24.
35. Hope C, Wu J, Tu W, Young J, Murray M. Association of medication adherence, knowledge, and skills with emergency department visits by adults 50 y or older with congestive heart failure. Am J Health Syst Pharm 2004;61:2043-9.
36. Senior V, Marteau TM, Weinman J. Self-reported adherence to cholesterol-lowering medication in patients with familial hypercholesterolemia: the role of illness perceptions. Cardiovasc Drugs Ther 2004;18:475–81.
37. Wee AS, MSB Mohamed Said, AB Md. Medication adherence status among rheumatoid arthritis patients. Int J Pharm Pharm Sci 2016:8:317-21.
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How to Cite
P., T., and P. T. “FACTORS CONTRIBUTING FOR NONCOMPLIANCE OF FOLLOW-UP CARE AMONG POST CARDIAC PATIENTS”. International Journal of Pharmacy and Pharmaceutical Sciences, Vol. 11, no. 10, Oct. 2019, pp. 22-25, doi:10.22159/ijpps.2019v11i10.34906.
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