A Pluralistic Qualitative Study of Medicine Adherence in Patients after Myocardial Infarction

Poster presentation by PhD candidate, Hannah Piekarz, at the the PhD Pharmacy Conference, April 2019, Henley Business School, University of Reading.

Hannah Piekarz

Professor Parastou Donyai and Mrs Catherine Langran

Reading School of Pharmacy, University of Reading, Reading, RG6 6UB. UK


Following an acute myocardial infarction (AMI), patients are prescribed a regime of cardioprotective medicines to prevent recurrent cardiovascular events and mortality. This is strongly recommended in international guidelines as clinical evidence shows improved long-term outcomes for patients who receive optimal therapy. Medication adherence in this patient group is poor, and current interventions such as physical memory aids or psychological motivational patient interviews have made improvements, but a single practical intervention with a significant effect to improve adherence has yet to be developed and implemented.

Medicine adherence comes from a complex set of behaviours, and this study aims to better understand the beliefs and experiences of medicine-taking in this group of patients. This will be completed through semi-structured interviews starting with people recruited from support groups, then snowballing will be used to draw in further appropriate participants. Data will be analysed using three methods in order to obtain multiple perspectives and a richer, more in-depth set of results. Grounded theory analysis will be used to model the processes involved in adherence to medication following AMI, interpretative phenomenological analysis will be used in order to better understand the experience from a patient’s perspective, and discourse analysis to illustrate the power relationships that exist through the process.

The results of this study could be used to better understand the problem of non-adherence in this group and then inform the design of an appropriate intervention to improve medicine adherence following AMI.