Knowledge, Attitude, and Practice of Coronary Heart Disease Patients Towards Antithrombotic Therapy

Overview

Journal BMC Public Health

Publisher Biomed Central

Date 2025 Feb 10

PMID 39930408

Authors

Yingqiang Du

Xingyou Cai

Xin Hong

Yuqiong Chen

Chao Chen

Junrong Gong

Guidong Xu

Jun Zhang

Yafei Li

Affiliations

Soon will be listed here.

Abstract

Background: The role of antithrombotic therapy in prognosticating patients with coronary heart disease (CHD) is crucial. This study evaluated the Knowledge, Attitude, and Practice (KAP) of CHD patients regarding antithrombotic therapy.

Methods: This cross-sectional study distributed questionnaires to collect data. Participants' demographic information was recorded, and their KAP scores were assessed. The Self-Efficacy for Appropriate Medication Use Scale (SEAMS) measured self-efficacy.

Results: The study comprised 639 individuals. The median scores were as follows: knowledge score 8 (IQR 6-10), attitude score 25 (IQR 23-27), and practice score 22 (IQR 20-24). Notably, up to 70% of patients incorrectly responded to questions about dosage and administration of antithrombotic agents, and approximately 40% lacked awareness of the treatment's importance and side effects. Low practice scores were independently linked to rural residence, low attitude scores, and poor self-efficacy. Furthermore, Predictive factors for low self-efficacy included being underweight, having a high family income, a short medical history, and low attitude scores.

Conclusions: The surveyed patients with CHD exhibited good attitudes, practices, and self-efficacy but demonstrated only median knowledge levels toward antithrombotic therapy, especially about the importance and precautions associated with antithrombotic treatment. Therefore, initiatives aimed at improving adherence to antithrombotic therapy among CHD patients should focus on the knowledge gaps, especially for patients in rural areas. Improving the patient KAP could help improve the physician-patient interaction.

References

Alzaman N, Wartak S, Friderici J, Rothberg M . Effect of patients' awareness of CVD risk factors on health-related behaviors. South Med J. 2013; 106(11):606-9. DOI: 10.1097/SMJ.0000000000000013. View

Twinamasiko N, Olum R, Gwokyalya A, Nakityo I, Wasswa E, Sserunjogi E . Assessing Knowledge, Attitudes and Practices Towards COVID-19 Public Health Preventive Measures Among Patients at Mulago National Referral Hospital. Risk Manag Healthc Policy. 2021; 14:221-230. PMC: 7829119. DOI: 10.2147/RMHP.S287379. View

Wu J, Tao Z, Song Z, Zhang Y, Sun H, Wang J . Validation and psychometric properties of the self-efficacy for Appropriate Medication Use Scale in elderly Chinese patients. Int J Clin Pharm. 2020; 43(3):586-594. DOI: 10.1007/s11096-020-01167-1. View

Fox K, Metra M, Morais J, Atar D . The myth of 'stable' coronary artery disease. Nat Rev Cardiol. 2019; 17(1):9-21. DOI: 10.1038/s41569-019-0233-y. View

Prattipati S, Mlangi J, Tarimo T, Kweka G, Thielman N, Bettger J . Knowledge, attitudes, and preventive practices regarding ischemic heart disease among HIV-positive individuals in northern Tanzania. Trop Med Int Health. 2021; 26(12):1652-1658. PMC: 11012094. DOI: 10.1111/tmi.13690. View

Amarasekara P, De Silva A, Swarnamali H, Senarath U, Katulanda P . Knowledge, Attitudes, and Practices on Lifestyle and Cardiovascular Risk Factors Among Metabolic Syndrome Patients in an Urban Tertiary Care Institute in Sri Lanka. Asia Pac J Public Health. 2015; 28(1 Suppl):32S-40S. PMC: 4834136. DOI: 10.1177/1010539515612123. View

Machaalani M, Fakhry B, Zwaideh M, Mendelek K, Mahmoud N, Hammoud T . Knowledge, Attitude, and Practice Toward Cardiovascular Diseases in the Lebanese Population. Glob Heart. 2022; 17(1):47. PMC: 9336688. DOI: 10.5334/gh.1138. View

Ni Z, Wu B, Yang Q, Yan L, Liu C, Shaw R . An mHealth Intervention to Improve Medication Adherence and Health Outcomes Among Patients With Coronary Heart Disease: Randomized Controlled Trial. J Med Internet Res. 2022; 24(3):e27202. PMC: 8943565. DOI: 10.2196/27202. View

Ejebe I, Jacobs E, Wisk L . Persistent differences in asthma self-efficacy by race, ethnicity, and income in adults with asthma. J Asthma. 2014; 52(1):105-13. PMC: 4288977. DOI: 10.3109/02770903.2014.947429. View

10.

Davis J, Fischl A, Beck J, Browning L, Carter A, Condon J . 2022 National Standards for Diabetes Self-Management Education and Support. Diabetes Care. 2022; 45(2):484-494. DOI: 10.2337/dc21-2396. View

11.

Xu H, Yu Y, Zhang Q, Hu H, Li M . Tailored Interventions to Improve Medication Adherence for Cardiovascular Diseases. Front Pharmacol. 2020; 11:510339. PMC: 7751638. DOI: 10.3389/fphar.2020.510339. View

12.

Risser J, Jacobson T, Kripalani S . Development and psychometric evaluation of the Self-efficacy for Appropriate Medication Use Scale (SEAMS) in low-literacy patients with chronic disease. J Nurs Meas. 2008; 15(3):203-19. DOI: 10.1891/106137407783095757. View

13.

Kahkonen O, Saaranen T, Kankkunen P, Lamidi M, Kyngas H, Miettinen H . Predictors of adherence to treatment by patients with coronary heart disease after percutaneous coronary intervention. J Clin Nurs. 2017; 27(5-6):989-1003. DOI: 10.1111/jocn.14153. View

14.

Andrade C, Menon V, Ameen S, Praharaj S . Designing and Conducting Knowledge, Attitude, and Practice Surveys in Psychiatry: Practical Guidance. Indian J Psychol Med. 2021; 42(5):478-481. PMC: 7750837. DOI: 10.1177/0253717620946111. View

15.

Shang P, Liu G, Zheng X, Ho P, Hu S, Li J . Association Between Medication Adherence and 1-Year Major Cardiovascular Adverse Events After Acute Myocardial Infarction in China. J Am Heart Assoc. 2019; 8(9):e011793. PMC: 6512098. DOI: 10.1161/JAHA.118.011793. View

16.

Xie Z, Liu K, Or C, Chen J, Yan M, Wang H . An examination of the socio-demographic correlates of patient adherence to self-management behaviors and the mediating roles of health attitudes and self-efficacy among patients with coexisting type 2 diabetes and hypertension. BMC Public Health. 2020; 20(1):1227. PMC: 7424981. DOI: 10.1186/s12889-020-09274-4. View

17.

Esagoff A, Cohen S, Chang G, Equils O, Van Orman S, Burnett A . Corrigendum to: 2531. Using Peer-to-Peer Education to Increase Awareness and Uptake of HPV Vaccine Among Chinese International Students. Open Forum Infect Dis. 2022; 9(5):ofac062. PMC: 8995071. DOI: 10.1093/ofid/ofac062. View

18.

Bello N, Mosca L . Epidemiology of coronary heart disease in women. Prog Cardiovasc Dis. 2004; 46(4):287-95. DOI: 10.1016/j.pcad.2003.08.001. View

19.

Yang C, Hui Z, Zeng D, Liu L, Lee D . Examining and adapting the information-motivation-behavioural skills model of medication adherence among community-dwelling older patients with multimorbidity: protocol for a cross-sectional study. BMJ Open. 2020; 10(3):e033431. PMC: 7202708. DOI: 10.1136/bmjopen-2019-033431. View

20.

Dong X, Liu Y, Wang A, Lv P . Psychometric properties of the Chinese version of the Self-Efficacy for Appropriate Medication Use Scale in patients with stroke. Patient Prefer Adherence. 2016; 10:321-7. PMC: 4798205. DOI: 10.2147/PPA.S101844. View