Patients with myocardial infarction history and nurse’s perspective in a medication adherence intervention adequacy




Nursing; Medication adherence; Health behavior; Intention.


This study identified the conditions increasing the feasibility, acceptability, and effectiveness potential of an intervention to promote the medication adherence. This was a qualitative, cross-sectional study design and a focus group technique with 15 patients and 14 nurses were used to identify the opinion about the intervention to adhere cardioprotective medications in primary healthcare service. The sessions were recorded in audio, transcribed in full, and discussed in detail to obtain agreement among the evaluators. EQUATOR checklist COREQ is used. The participants suggest that the intervention should be applied in a written and verbal way lasting approximately 30 minutes and reinforcement with a thirty-day interval. The forgetting, complexity of the therapeutic regimen, lack of free access to medications, limited understanding of their disease, and the patient's personal choice of not adhering, have been mentioned as barriers to adherence. Participants adjusted the mode of application and dose of the intervention.


Ajzen, I. (1991). The Theory of Planned Behavior. Organizational Behavior and Human Decision Processes, 50, 179-111.

Armitage, J. C., & Conner, M. (2000). Social cognition models and health behaviour: a structured review. Psychology & Health, 15(2), 173-189.

Armitage C. J. (2009). Effectiveness of experimenter-provided and self-generated implementation intentions to reduce alcohol consumption in a sample of the general population: a randomized exploratory trial. Health Psychology, 28(5), 545–553.

Banerjee, A., Khandelwal, S., Nambiar, L., Saxena, M., Peck, V., Moniruzzaman, M., Faria Neto, J. R., Quinto, K. C., Smyth, A., Leong, D., & Werba, J. P. (2016). Health system barriers and facilitators to medication adherence for the secondary prevention of cardiovascular disease: a systematic review. Open Heart, 3(2), e000438.

Bilondi, S. S., Noghabi, A. D., & Aalami, H. (2022). The relationship between illness perception and medication adherence in patients with diabetes mellitus type II: illness perception and medication adherence. Journal of preventive medicine and hygiene, 62(4), E966–E971.

Bokhour, B. G., Fix, G. M., Mueller, N. M., Barker, A. M., Lavela, S. L., Hill, J. N., Solomon, J. L., & Lukas, C. V. (2018). How can healthcare organizations implement patient-centered care? Examining a large-scale cultural transformation. BMC Health Services Research, 18(1), 168.

Castellano, J. M., Fuster, V., Jennings, C., Prescott, E., & Bueno, H. (2017). Role of the polypill for secondary prevention in ischaemic heart disease. European Journal of Preventive Cardiology, 24(3_suppl), 44–51.

Collet, J. P., Thiele, H., Barbato, E., Barthélémy, O., Bauersachs, J., Bhatt, D. L., Dendale, P., Dorobantu, M., Edvardsen, T., Folliguet, T., Gale, C. P., Gilard, M., Jobs, A., Jüni, P., Lambrinou, E., Lewis, B. S., Mehilli, J., Meliga, E., Merkely, B., Mueller, C., & ESC Scientific Document Group (2020). 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. European Heart Journal, ehaa575.

Davis, R., Campbell, R., Hildon, Z., Hobbs, L., & Michie, S. (2015). Theories of behaviour and behaviour change across the social and behavioural sciences: a scoping review. Health Psychology Review, 9(3), 323–344.

Du, L., Cheng, Z., Zhang, Y., Li, Y., & Mei, D. (2017). The impact of medication adherence on clinical outcomes of coronary artery disease: A meta-analysis. European Journal of Preventive Cardiology, 24(9), 962–970.

Gollwitzer, P. M. (1999). Implementation intentions: Strong effects of simple plans. American Psychologist, 54(7), 493–503.

Hagger, M. S., Luszczynska, A., de Wit, J., Benyamini, Y., Burkert, S., Chamberland, P. E., Chater, A., Dombrowski, S. U., van Dongen, A., French, D. P., Gauchet, A., Hankonen, N., Karekla, M., Kinney, A. Y., Kwasnicka, D., Hing Lo, S., López-Roig, S., Meslot, C., Marques, M. M., Neter, E., & Gollwitzer, P. M. (2016). Implementation intention and planning interventions in Health Psychology: Recommendations from the Synergy Expert Group for research and practice. Psychology & Health, 31(7), 814–839.

Khatib, R., Marshall, K., Silcock, J., Forrest, C., & Hall, A. S. (2019). Adherence to coronary artery disease secondary prevention medicines: exploring modifiable barriers. Open Heart, 6(2), e000997.

Knuuti, J., Wijns, W., Saraste, A., Capodanno, D., Barbato, E., Funck-Brentano, C., Prescott, E., Storey, R. F., Deaton, C., Cuisset, T., Agewall, S., Dickstein, K., Edvardsen, T., Escaned, J., Gersh, B. J., Svitil, P., Gilard, M., Hasdai, D., Hatala, R., Mahfoud, F., & ESC Scientific Document Group (2020). 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. European Heart Journal, 41(3), 407–477.

Krueger, R. A., Ashwani, K. (2015). Focus Group: A pratical guide for applied research (5th ed.). Thousand Oaks: SAGE Publications.

Leventhal, H., Benyamini, Y., Brownlee, S., Diefenbach, M., Leventhal, E.A., Patrick-Miller, L., & Robitaillc, C. (1997). Illness Representations: Theoretical Foundations. In: Petrie, K.J. and Weinman, J., Eds., Perceptions of Health and Illness, Harwood Academic Publisher, Amsterdam.

Lourenço, L. B., Rodrigues, R. C., Ciol, M. A., São-João, T. M., Cornélio, M. E., Dantas, R. A., & Gallani, M. C. (2014). A randomized controlled trial of the effectiveness of planning strategies in the adherence to medication for coronary artery disease. Journal of advanced nursing, 70(7), 1616-1628.

Luszczynska, A., Sobczyk, A., & Abraham, C. (2007). Planning to lose weight: randomized controlled trial of an implementation intention prompt to enhance weight reduction among overweight and obese women. Health Psychology, 26(4), 507–512.

Mosleh, S. M., & Almalik, M. M. (2016). Illness perception and adherence to healthy behaviour in Jordanian coronary heart disease patients. European Journal of Cardiovascular Nursing, 15(4), 223–230.

Nur K. (2018). Illness perception and cardiovascular health behaviour among persons with ischemic heart disease in Indonesia. International Journal of Nursing Sciences, 5(2), 174–180.

Sniehotta, F. F., Schwarzer, R., Scholz, U., & Schüz, B. (2005). Action planning and coping planning for long-term lifestyle change: Theory and assessment. European Journal of Social Psychology, 35(4), 565-576.

Sniehotta, F. F., Scholz, U., & Schwarzer, R. (2006). Action plans and coping plans for physical exercise: A longitudinal intervention study in cardiac rehabilitation. British Journal of Health Psychology, 11(Pt 1), 23–37.

Sidani, S.; Jo Braden, C. (2011). Design, evaluation, and translation of nursing interventions. Chichester: Wiley-Blackwell.

Simpson, S. H., Farris, K. B., Johnson, J. A., & Tsuyuki, R. T. (2000). Using focus groups to identify barriers to drug use in patients with congestive heart failure. Pharmacotherapy, 20(7), 823–829.

Thomson, P., Rushworth, G. F., Andreis, F., Angus, N. J., Mohan, A. R., & Leslie, S. J. (2020). Longitudinal study of the relationship between patients' medication adherence and quality of life outcomes and illness perceptions and beliefs about cardiac rehabilitation. BMC Cardiovascular Disorders, 20(1), 71.

Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349–357. c/mzm042

Schmittdiel, J. A., Nichols, G. A., Dyer, W., Steiner, J. F., Karter, A. J., & Raebel, M. A. (2015). Health care system-level factors associated with performance on Medicare STAR adherence metrics in a large, integrated delivery system. Medical Care, 53(4), 332–337.

van der Laan, D. M., Elders, P. J., Boons, C. C., Bosmans, J. E., Nijpels, G., & Hugtenburg, J. G. (2017). The (cost-)effectiveness of a patient-tailored intervention programme to enhance adherence to antihypertensive medication in community pharmacies: study protocol of a randomised controlled trial. Trials, 18(1), 29.

Wolf, M. S., Bennett, C. L., Davis, T. C., Marin, E., & Arnold, C. (2005). A qualitative study of literacy and patient response to HIV medication adherence questionnaires. Journal of Health Communication, 10(6), 509–517.

Zullig, L. L., Ramos, K., & Bosworth, H. B. (2017). Improving Medication Adherence in Coronary Heart Disease. Current Cardiology Reports, 19(11), 113.




How to Cite

PEDROSA, R. B. dos S. .; GALLANI, M. C. B. J. .; NUNCIARONI, A. T. .; MARQUES, M. D. .; DUVAL, K. .; GALHARDI, N. M. .; RODRIGUES , R. C. M. . Patients with myocardial infarction history and nurse’s perspective in a medication adherence intervention adequacy . Research, Society and Development, [S. l.], v. 11, n. 9, p. e3811931511, 2022. DOI: 10.33448/rsd-v11i9.31511. Disponível em: Acesso em: 6 oct. 2022.



Health Sciences