Date of Award

2-2015

Document type

Thesis

Degree Name

MSc by research (Master of Science by research)

First Supervisor

Dr. Frank Doyle

Second Supervisor

Professor Dermot Kenny

Third Supervisor

Professor David Foley

Funder/Sponsor

I would like to acknowledge the unrestricted educational support from Merck Sharpe and Dome and Daiichi Sankyo towards student fees.

Keywords

Aspirin Adherence, Psychological Indicators

Abstract

Background:

Although prescribed to approximately 90% of persons with cardiovascular disease (CVD), it is estimated that adherence to aspirin therapy is only approximately 70%. Established psychosocial predictors of adherence include patient beliefs about medicines and illness, depression and social support. However, no study has assessed these simultaneously to determine the best predictor of adherence when using an objective measure of aspirin adherence.

Method:

After ethical approval was received we surveyed 106 patients with cardiovascular disease from Beaumont Hospital who participated in a study of aspirin effectiveness in patients with stable coronary artery disease using a direct assay measurement (thromboxane B2). The following measures were used to assess the psychological predictors of adherence: Beliefs about Medicines Questionnaire, Brief Illness Perception Questionnaire, Patient Health Questionnaire, 2 and ENRICHD Social Support Inventory. These were administered either by post or by interview to patients who were willing and able to consent for the current substudy. Data was amalgamated with the initial study and analysed to determine the best predictors of aspirin adherence.

Results:

There was a 56% response rate to the survey (n=106). The mean age was 63 years; 66% had an effective response and 34% had an ineffective response (defined as serum thromboxane B2 levels of greater than 2.2ng/ml). There was no significant correlation between psychological adherence predictors and thromboxane level or self-reported non-adherence.

Conclusion:

Although most psychological variables correlated significantly with each other as expected, no psychological variable was associated with thromboxane level or self-reported adherence. Patients who had higher weight and alcohol consumption were significantly more likely to be non-adherent as measured by thromboxane. Method-After ethical approval was received we surveyed 106 patients with cardiovascular disease from Beaumont Hospital who participated in a study of aspirin effectiveness in patients with stable coronary artery disease using a direct assay measurement (thromboxane B2). The following measures were used to assess the psychological predictors of adherence: Beliefs about Medicines Questionnaire, Brief Illness Perception Questionnaire, Patient Health Questionnaire-2 and ENRICHD Social Support Inventory. These were administered either by post or by interview to patients who were willing and able to consent for the current sub-study. Data was amalgamated with the initial study and analysed to determine the best predictors of aspirin adherence.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License.

File Size

2.06 MB

Comments

A thesis submitted for the degree of Master of Science from the Royal College of Surgeons in Ireland in 2015.

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