Preview

Russian Sklifosovsky Journal "Emergency Medical Care"

Advanced search

Psychosocial Factors Influencing Adherence to Cardiac Rehabilitation in Patients After Myocardial Infarction

https://doi.org/10.23934/2223-9022-2025-14-2-379-386

Abstract

BACKGROUND Compliance with medical recommendations and adherence to cardiac rehabilitation remains one of the pressing problems in helping patients who have suffered a myocardial infarction (MI). Additional difficulties include insufficient research in this area and limited tools. One possible solution may be a qualitative method such as a semi-structured McGill Illness Narrative Interview to describe the disease.

AIM OF THE STUDY to identify factors influencing adherence to cardiac rehabilitation.

MATERIAL AND METHODS The study was conducted at the Federal State Budgetary Institution E.I. Chazov National Medical Research Center of Cardiology from April to August 2023. The sample included 17 people (14 men, 3 women) aged 36 to 62 years, the average age was 51 years. Of these, 7 people were admitted directly by ambulance to the cardiology center at the time of myocardial infarction (3–7 days ago), 10 people underwent treatment for the cardiovascular system in various departments of the cardiology center and had myocardial infarction in the past (from 2 months to 3 years ago). Each respondent was interviewed once, in an individual format, mainly in the cardiac rehabilitation department, in the office of a medical psychologist.

RESULTS AND CONCLUSIONS Insufficient awareness of the signs and possibilities of first aid for myocardial infarction was found among the target group. It is advisable to allocate additional consultations to increase awareness of cardiac rehabilitation, strengthen motivation and draw up a plan for independent patient actions. Involvement of people close to the patient in the cardiac rehabilitation process can have a positive impact on achieving the desired changes.

CONCLUSION The use of qualitative research methods allowed additional factors that influence poor adherence to cardiac rehabilitation to be identified. The data obtained can be used by cardiologists, medical psychologists, and other members of the medical team to improve the quality of interaction and motivate patients to change.

About the Authors

A. A. Gerasimova
Academician E.I. Chazov National Medical Research Center of Cardiology, Cardiac Rehabilitation Department
Russian Federation

Anna A. Gerasimova - Medical Psychologist of the Cardiac Rehabilitation Department, Academician E.I. Chazov National Medical Research Center of Cardiology.

Akademika Chazova Str. 15A, Moscow, 121552



A. B. Kholmogorova
N.V. Sklifosovsky Research Institute for Emergency Medicine; Moscow State University of Psychology and Education
Russian Federation

Alla B. Kholmogorova - Professor, Doctor of Psychological Sciences, Dean of the Faculty of “Counseling and Clinical Psychology”, Head of the Department of Clinical Psychology and Psychotherapy, Moscow State University of Psychology and Education; Head of the Psychological Department, N.V. Sklifosovsky Research Institute for Emergency Medicine.

Bolshaya Sukharevskaya Sq. 3, Moscow, 129090; Sretenka Str. 29, Moscow, 127051



N. V. Pogosova
Academician E.I. Chazov National Medical Research Center of Cardiology, Cardiac Rehabilitation Department
Russian Federation

Nana V. Pogosova - Professor, Doctor of Medical Sciences, Deputy Director General for Scientific and Analytical Work and Preventive Cardiology, Academician E.I. Chazov National Medical Research Center of Cardiology.

Akademika Chazova Str. 15A, Moscow, 121552



A. K. Ausheva
Academician E.I. Chazov National Medical Research Center of Cardiology, Cardiac Rehabilitation Department; Peoples Friendship University of Russia, Medical Institute
Russian Federation

Aza K. Ausheva - Candidate of Medical Science, Head of the Cardiac Rehabilitation Department, Cardiologist, Leading Researcher at the Laboratory of Preventive Cardiology, Academician E.I. Chazov National Medical Research Center of Cardiology; Assistant at the Department of Evidence-Based Medicine, Medical Institute of Peoples Friendship University of Russia.

Akademika Chazova Str. 15A, Moscow, 121552; Miklukho-Maklaya Str. 6, Moscow, 117198



References

1. Matskeplishvili S, Kontsevaya A. Cardiovascular Health, Disease, and Care in Russia. Circulation. 2021;144(8):586–588. PMID: 34424769 https://doi.org/10.1161/CIRCULATIONAHA.121.055239

2. Shalnova SA, Drapkina OM, Kutsenko VA, Kapustina AV, Muromtseva GA, Yarovaya EB, et al. Myocardial infarction in the population of some Russian regions and its prognostic value. Russian Journal of Cardiology. 2022;27(6):4952. (In Russ.). https://doi.org/10.15829/1560-4071-2022-4952

3. Samorodskaya IV, Barbarash ОL, Kashtalap VV, Starinskaya МА. Mortality from Myocardial Infarction in Russia in the Years 2006 And 2015. Russian Journal of Cardiology. 2017;(11):22–26. (In Russ.). https://doi.org/10.15829/1560-4071-2017-11-22-26

4. Barbarash OL, Sedykh DYu, Gorbunova EV. Key Factors Determining the Risk of Recurrent Myocardial Infarction. Serdtse: zhurnal dlya praktikuyushchikh vrachey. 2017;16(1):26–31. (In Russ.) https://doi.org/10.18087/rhj.2017.1.2280

5. Mehra VM, Gaalema DE, Pakosh M, Grace SL. Systematic review of cardiac rehabilitation guidelines: Quality and scope. Eur J Prev Cardiol. 2020;27(9):912–928. PMID: 31581808 https://doi.org/10.1177/2047487319878958

6. Kabboul NN, Tomlinson G, Francis TA, Grace SL, Chaves G, Rac V, et al. Comparative Effectiveness of the Core Components of Cardiac Rehabilitation on Mortality and Morbidity: A Systematic Review and Network Meta-Analysis. J Clin Med. 2018;7(12):514. PMID: 30518047 https://doi.org/10.3390/jcm7120514

7. Anderson L, Oldridge N, Thompson DR, Zwisler AD, Rees K, Martin N, et al. Exercise-Based Cardiac Rehabilitation for Coronary Heart Disease: Cochrane Systematic Review and Meta-Analysis. J Am Coll Cardiol. 2016;67(1):1–12. PMID: 26764059 https://doi.org/10.1016/j.jacc.2015.10.044

8. Kontsevaya AV, Veretennikova AV, Rozanov VB, Khudyakov MB, Drapkina OM. Characteristics of a 1-year outpatient management of patients after myocardial infarction: data from a Russian multicenter study. Russian Journal of Cardiology. 2022;27(5):5004. (In Russ.). https://doi.org/10.15829/1560-4071-2022-5004

9. Pogosova NV, |Oganov RG, Boytsov SA, Ausheva AK, Sokolova OYu, Kursakov AA, et al. Secondary prevention in patients with coronary artery disease in Russia and Europe: results from the Russian part of the EUROASPIRE V survey. Cardiovascular Therapy and Prevention. 2020;19(6):2739. (In Russ.). https://doi.org/10.15829/1728-8800-2020-2739

10. Pogosova NV, Boytsov SA, Ausheva AK, Sokolova OY, Arutyunov AA, Osipova IV, et al. Drug Therapy and Adherence in Patients With Coronary Heart Disease: Results of the Russian Part of the EUROASPIRE V International Multicenter Study. Kardiologiia. 2021;61(8):4–13. (In Russ.). https://doi.org/10.18087/cardio.2021.8.n1650

11. Jarab AS, Mansour RZ, Muflih S, Qeremc WA, Heshmeha SRA, Mukattash T, et al. Medication non-adherence among outpatients with myocardial infarction: A hospital-based study. Clinical Epidemiology and Global Health. 2024;28:101682. https://doi.org/10.1016/j.cegh.2024.101682

12. Gehi AK, Ali S, Na B, Whooley MA. Self-reported Medication Adherence and Cardiovascular Events in Patients with Stable Coronary Heart Disease: The Heart and Soul Study. Arch Intern Med. 2007;167(16):1798. PMID: 17846400 https://doi.org/10.1001/archinte.167.16.1798

13. Crowley MJ, Zullig LL, Shah BR, Shaw RJ, Lindquist JH, Peterson ED, et al. Medication Non-Adherence After Myocardial Infarction: An Exploration of Modifying Factors. J Gen Intern Med. 2015;30(1):83–90. PMID: 25361685 https://doi.org/10.1007/s11606-014-3072-x

14. Nadery Y, Khorasani P, Feizi A, Parvizy S. Causes of nonadherence to treatment in people with myocardial infarction: Content analysis. J Educ Health Promot. 2021;10:330. PMID: 34761016 https://doi.org/10.4103/jehp.jehp_92_21 eCollection 2021

15. Freier C, Heintze C, Herrmann WJ. Prescribing and medical non-adherence after myocardial infarction: qualitative interviews with general practitioners in Germany. BMC Family Practice. 2020;21(1):81. PMID: 32384915 https://doi.org/10.1186/s12875-020-01145-6

16. Ye S, Krupka DJ, Davidson KW. Diagnosing Medication Non-Adherence in a Patient with Myocardial Infarction. Front Psychol. 2012;3:267. PMID: 22876236 https://doi.org/10.3389/fpsyg.2012.00267 eCollection 2012

17. Groleau D, Young A, Kirmayer LJ. The McGill Illness Narrative Interview (MINI): an interview schedule to elicit meanings and modes of reasoning related to illness experience. Transcult Psychiatry. 2006;43(4):671–691. PMID: 17166953 https://doi.org/10.1177/1363461506070796

18. Fitilev SB, Vozzhaev AV, Kliuev DA, Shkrebniova II. Multivariate analysis of medication adherence among outpatients with stable coronary artery disease. Good Clinical Practice. 2021;(4):44–52. (In Russ.). https://doi.org/10.37489/2588-0519-2021-4-44-52

19. Carrillo A, Belnap BH, Rothenberger SD, Feldman R, Rollman BL, Celano CM. Psychosocial predictors of health behavior adherence in heart-failure patients with comorbid depression: a secondary analysis of the Hopeful Heart trial. BMC Psychology. 2024;12(1):328. PMID: 38835104 https://doi.org/10.1186/s40359-024-01816-4

20. Cobb LK, McAdams-DeMarco MA, Huxley RR, Woodward M, Koton S, Coresh J, et al. The Association of Spousal Smoking Status with the Ability to Quit Smoking: The Atherosclerosis Risk in Communities Study. Am J Epidemiol. 2014;179(10):1182–1187. PMID: 24699782 https://doi.org/10.1093/aje/kwu041

21. Groleau D, Whitley R, Lespérance F, Kirmayer LJ. Spiritual reconfigurations of self after a myocardial infarction: Influence of culture and place. Health Place. 2010;16(5):853–860. PMID: 20471300 https://doi.org/10.1016/j.healthplace.2010.04.010


Review

For citations:


Gerasimova A.A., Kholmogorova A.B., Pogosova N.V., Ausheva A.K. Psychosocial Factors Influencing Adherence to Cardiac Rehabilitation in Patients After Myocardial Infarction. Russian Sklifosovsky Journal "Emergency Medical Care". 2025;14(2):379-386. (In Russ.) https://doi.org/10.23934/2223-9022-2025-14-2-379-386

Views: 12


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2223-9022 (Print)
ISSN 2541-8017 (Online)