A Study of Adherence to Physicians' Instructions for Physical Activity among Patients with First-Time Acute Myocardial Infarction.

Abstract

BACKGROUND: Myocardial Infarction (MI) survivors are especially at increased risk for recurrent MI. Because of this increased risk of recurrences, cardiac rehabilitation should be carried out within the treatment process to decrease the risk of a second MI. Since there is no current Physical Activity rehabilitative program in Armenia and rehabilitative Physical activity is promoted only through physicians' advice for which adherence is unknown it will be crucial to know 1) the level of non-adherence to physicians' instructions for PA, 2) the proportion of MI patients reportedly receiving instructions for PA from their physicians and various factors associated with them. METHODOLOGY: A cross-sectional telephone survey of MI patients was utilized for assessing the three research questions. Sample size for this study was 110. Study population was MI patients aged 18 to 70 who were treated at the Yerevan institute of Cardiology from 2007 to 2008 and who can speak and understand Armenian language. Systematic random sampling was conducted to select the sample of MI patients who met the inclusion and exclusion criteria of the study. The survey questionnaire was designed and adapted from an existing standard questionnaire International physical activity questionnaire. Additional questions were added to more-completely answer the research questions. RESULTS: Of the study subjects, 21.8% (24/110) of the study population reported adhering poorly, 52.7% (58/110) reported adhering fairly and 25.5% (28/110) reported adhering well to physicians' instructions for PA. Age was found to be positively associated with the level of adherence to physicians' instructions (adjusted OR=1.12, p=0.009). Amazingly, smoking status appeared to be marginally positively associated with the level of adherence to physicians’ instructions (adjusted OR=2.91, p=0.072). Out of the approached sample, 72.7% (80/110) reported that they received instructions for physical activity from their physicians, with only 27.3% (30/110) of participants not reporting receiving such instructions. Age was negatively associated with receiving instructions for PA (adjusted OR=0.89, p=0.023). CONCLUSION: Study findings suggest that those MI patients who have more risk factors reportedly adhering better to physicians’ instructions for PA than those with fewer risk factors. Older patients were more likely to report not receiving instructions from their physicians than younger patients.