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Adherence to Secondary Prevention Measures after Acute Coronary Syndrome in Patients Associated Exclusively with the Public and Private Healthcare Systems in Brazil

2022; RELX Group (Netherlands); Linguagem: Inglês

10.2139/ssrn.4094242

1556-5068

Ingrid Maria Novais Barros de Carvalho Costa, Danielle Góes da Silva, Joselina Luzia Menezes Oliveira, José Rodrigo Santos Silva, Luciana F. Alves, Larissa Pereira, Fabrício Anjos de Andrade, Juliana de Góes Jorge, Larissa Marina Santana Mendon de Oliveira, Rebeca de Almeida, Victor Batista Oliveira, Larissa Santos Martins, Jamille Oliveira Costa, Márcia Ferreira Cândido de Souza, Sílvia Maria Voci, Marcos Antônio Almeida-Santos, Felipe J. Aidar, Leonardo Baumworcele, Antônio Carlos Sobral Sousa,

Blood Pressure and Hypertension Studies

Adherence to secondary prevention measures after acute coronary syndrome (ACS) is essential to prevent disease recurrence. In Brazil, the Brazilian Unified Health System (SUS in Portuguese), and the private healthcare system (PHCS) coexist. We aimed to evaluate the adherence to secondary prevention in patients with ACS who were assisted by the SUS and PHCS. In this longitudinal prospective study, patients with ACS were admitted to the four cardiological reference hospitals of Sergipe, of which three and one assisted PHCS and SUS users, respectively. We analyzed the two patient care models with multiple logistic regression models for adherence to physical activity, pharmacotherapy, and smoking cessation. We enrolled 581 volunteers in this study: 44.1% from the SUS and 55.9% from the PHCS. PHCS users showed a greater adherence to pharmacotherapy at both 30 and 180 (p=0.001) days after ACS with better results in all classes of medications (p<0.05) than did SUS users. They also showed better adherence to physical activity (p=0.047). There was no distinction between the groups regarding smoking cessation. The secondary prevention measures after ACS were more effective in PHCS users than in SUS users due to better adherence, especially to pharmacotherapy and regular physical activity.