The influence of patient expectations on adherence to treatment regimen after myocardial infarction

Patient Educ Couns. 2022 Feb;105(2):426-431. doi: 10.1016/j.pec.2021.05.030. Epub 2021 May 23.


Objective: In-hospital patient education is one of the elements affecting patient adherence to treatment regimen after myocardial infarction (MI). Its effectiveness is determined by educator and patient-dependent factors. Previous studies did not identify patient expectations as an independent determinant of successful education. The aim of this study was to assess whether patient knowledge and expectations affect adherence to treatment regimen in a 1-year follow-up.

Methods: This was a single-center, cohort study with a 1-year follow-up. Patient knowledge and expectations were evaluated using the Readiness for Hospital Discharge after Myocardial Infarction Scale (RHD-MIS scale). Medication adherence (including angiotensin converting enzyme inhibitors (ACEI), P2Y12 receptor inhibitors and statins) was verified based on prescription refill data extracted from The National Health Fund database.

Results: The study included 225 patients aged 30-91 years (mean age 62.9 ± 11.9 years). In the 4th quarter of follow-up, patients with the highest expectations had lower adherence regarding ACEI (p = 0.01), P2Y12 receptor inhibitors (p = 0.03) and the combination of all three analysed medications (p = 0.003).

Conclusions: The initial results suggest presence of a relationship between patient expectations and long-term adherence to treatment.

Practice implications: Post-MI patient education directed at fulfilling or modification of patient expectations could possibly improve execution of treatment regimen.

Keywords: Adherence to medication; Myocardial infarction; Readiness for hospital discharge.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Cohort Studies
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / therapeutic use
  • Medication Adherence
  • Middle Aged
  • Motivation
  • Myocardial Infarction* / drug therapy


  • Angiotensin-Converting Enzyme Inhibitors
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors