Role of psychosocial factors in long-term adherence to secondary prevention measures after myocardial infarction: a longitudinal analysis.

Abstract

PURPOSE:

Psychosocial factors have been linked to myocardial infarction (MI) outcomes. Whether psychosocial factors affect post-MI long-term adherence to secondary prevention recommendations remains uncertain.

METHODS:

Patients ≤65 years (n = 616) were assessed for optimism, perceived social support (PSS), sense of coherence (SOC), anxiety, and depression at initial hospitalization for acute MI (1992-1993). Adherence to secondary prevention measures was recorded in interviews 3-6 months, 1-2, 5, and 10-13 years after MI. Prevention score (proportion of recommendations met) was developed based on: (1) medication adherence; (2) exercise; (3) nonsmoking; (4) healthy diet; (5) maintaining recommended body weight. Associations between psychosocial factors and prevention scores were estimated using Generalized Estimating Equation models. The role of the prevention score in long-term survival was assessed using time-dependent Cox regression analysis.

RESULTS:

Average follow-up prevention scores ranged from 0.70 to 0.80 (SD, ≈0.20). After multivariable adjustment, PSS (β = 0.087, P = .002, per 1 SD increase) and SOC (β = 0.082, P = .006, per 1 SD increase) were positively associated with secondary prevention adherence. The prevention score predicted survival over 23-year follow-up (adjusted hazard ratio = 0.79; 95% CI: 0.68-0.91, per 1 SD increase).

CONCLUSIONS:

Psychosocial factors following MI, particularly PSS and SOC, were associated with long-term adherence to secondary prevention measures.

• Authors: Michal Nachshol, Ido Lurie, Yael Benyamini, Uri Goldbourt, Yariv Gerber
• Journal: Annals of epidemiology (Ann Epidemiol) Vol. 52 Pg. 35-41 (12 2020) ISSN: 1873-2585 [Electronic] United States
• PMID: 33031935 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2020 Elsevier Inc. All rights reserved.

Topics

• Aged
• Anxiety (epidemiology, psychology)
• Depression (epidemiology, psychology)
• Female
• Humans
• Longitudinal Studies
• Male
• Middle Aged
• Myocardial Infarction (mortality, prevention & control, psychology)
• Prospective Studies
• Secondary Prevention
• Sense of Coherence
• Social Support
• Surveys and Questionnaires
• Survivors
• Treatment Adherence and Compliance