Assessing Antihypertensive Therapy Nonadherence in Cardiac Rehabilitation Patients using the Morisky Medication Adherence Scale (MMAS-8)

Abstract

In a patient population where disease states are being newly navigated and the emphasis is on improving cardiac health, promoting medication adherence can help prevent poor outcomes. The outpatient phase II cardiac rehabilitation (CR) program has no evidence-based process for assessing medication adherence. This project's aim was to implement the Morisky Medication Adherence Scale (MMAS-8) among CR patients to determine if it increased identification of patients not adhering to antihypertensives over the current practice, and to identify reasons for nonadherence. Using a between-subjects design, the pre-implementation group was retrospectively assessed for answers to the current questions (August 15-October 7, 2022) and the practice change group received the MMAS-8 (October 10-December 2, 2022). Descriptive statistics were used to compare the two groups and the Chi-Square test was used to determine associations among categorical data. Pre-implementation group (n=51), 45 out of 51, or 88%, were adherent and 6 out of 51, or 12%, were nonadherent. Practice change group (n=26), low adherence was 4 out of 26 (16%), medium 11 out of 26 (42%), and high 11 out of 26 (42%). Statistically significant associations: gender/adherence in pre-implementation group (X^2= 3.934, df= 1, N=51, p=0.047); age/adherence in MMAS-8 group (X^2= 9.672, df= 4, N=26, p=0.046) suggesting age may influence how beneficial the MMAS-8 assesses adherence. The MMAS-8 increased the number of identified nonadherent patients by approximately 400% (58% vs. 12%) and discovered eight reasons. Medication adherence can be improved using evidence-based measures. Quantifying and determining attitudes for nonadherence can provide insight and correct it earlier.