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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; Elsevier BV; Volume: 29; Linguagem: Inglês

10.1016/j.pmedr.2022.101973

2211-3355

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

Medication Adherence and Compliance

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 either SUS or PHCS. In this longitudinal prospective study, patients with ACS were admitted to the four cardiological reference hospitals of Sergipe, three of which assisted PHCS users, and one, SUS users. 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 SUS and 55.9 % from PHCS. PHCS users showed 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 SUS users did. 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.