Acute Coronary Syndromes (ACS)NCT07288502
Adherence to Secondary Prevention Drugs and Influencing Factors After Acute Coronary Syndrome in Patients at a Tertiary Center in Nepal
An observational study of Acute Coronary Syndromes (ACS) and Adherence, run by Institute of medicine, Maharagjung medical campus at 1 site in Nepal.
Trial summary
This study aimed to assess adherence to secondary prevention medications among patients in Nepal following an Acute Coronary Syndrome (ACS) event and to identify factors affecting adherence. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Acute Coronary Syndromes (ACS), Adherence
- What is being tested?
- My Experience of Taking Medicines (MYMEDS) questionnaire
- How many people
- 109 participants
- Where
- 1 siteNepal
- Study dates
- 1 Aug 2024to 1 Aug 2025
- Phase
- Observational
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: A sample of adult patients (age ≥18 years) who have either come to OPD for follow-up or have been readmitted for having cardiac complications months after surviving ACS (including STEMI, NSTEMI, and unstable angina) in Manmohan Cardiothoracic Vascular and Transplant Centre, Nepal was selected via convenience sampling.
Who may be able to join
- Patients diagnosed with ACS, including ST-Elevation Myocardial Infarction (STEMI), Non-ST-Elevation Myocardial Infarction (NSTEMI), or Unstable Angina within the last 12 months
- Patients aged 18 years and older.
- Patients willing to participate and provide informed consent for the study.
Who cannot join
- Individuals who have not been diagnosed with ACS or those with other acute or chronic conditions that might influence medication adherence unrelated to ACS.
- Patients with cognitive impairments or mental health issues that prevent them from understanding or responding accurately to the study questionnaires.
- Patients with severe chronic conditions (e.g., terminal illness, advanced dementia) that may affect their ability to adhere to medication regimens.
Trial locations and contacts
1 site in 1 country.
Nepal1 site
Manmohan Cardiothoracic Vascular and Transplant Centre
Kathmandu, 44600
About this study
Official title: Adherence to Secondary Prevention Medications and Factors Influencing Adherence, After Acute Coronary Syndrome in Patient Attending a Tertiary Care Centre Of Nepal: A Descriptive Cross-sectional Study
This study aimed to assess adherence to secondary prevention medications among patients in Nepal following an Acute Coronary Syndrome (ACS) event and to identify factors affecting adherence. ACS was a major cause of morbidity and mortality globally and in Nepal, requiring effective secondary prevention to minimize recurrent cardiovascular events. However, adherence to prescribed medications remained low, especially in low- and middle-income countries like Nepal. Poor adherence could lead to increased healthcare burden, worsened patient outcomes, and higher mortality rates. To address this, the study evaluated patients' medication adherence through the MYMEDS questionnaire, a self-reported tool that was positively received for its simplicity and clarity. Conducted at the Manmohan Cardiothoracic Vascular and Transplant Centre in Nepal, the study involved a sample of adult patients who were readmitted or attending follow-ups post-ACS. The research gathered data on patient demographics, socioeconomic factors, clinical characteristics, and self-reported adherence barriers, analyzing these with SPSS to assess correlations with clinical outcomes.
The 12-month project consisted of phases for ethical approvals, data collection, analysis, and report dissemination. By identifying key barriers to adherence, the study aimed to inform targeted interventions that could enhance medication adherence, improve long-term cardiovascular outcomes, and reduce healthcare burdens in Nepal and other similar settings.
- Conditions
- Acute Coronary Syndromes (ACS), Adherence
- Being tested
- My Experience of Taking Medicines (MYMEDS) questionnaire
- Medical subject headings
- Acute Coronary Syndrome
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
My Experience of Taking Medicines (MYMEDS) questionnaireOther
This study does not involve a clinical or therapeutic intervention. Instead, it employs an assessment-based approach to evaluate medication adherence among post-Acute Coronary Syndrome (ACS) patients. The core instrument is the My Experience of Taking Medicines (MYMEDS) questionnaire, a validated, self-reported tool specifically designed to identify modifiable barriers to adherence in individuals prescribed secondary prevention medications. The questionnaire is structured into six sections that systematically explore patients' current medication use, their understanding and satisfaction with their prescribed regimen, specific concerns about the medicines, practical challenges in medication administration, difficulties in integrating medications into daily routines, and a detailed assessment of adherence to each individual secondary prevention drug over the preceding month. Utilizing primarily Likert-scale responses, the tool provides a nuanced understanding of adherence behaviors and t
What is being measured
The primary outcome is the main question the study is designed to answer.
Medication adherence to secondary prevention medications measured using the My Experience of Taking Medicines (MYMEDS) questionnaire
Medication adherence to prescribed secondary prevention medications will be assessed using Section 6 of the My Experience of Taking Medicines (MYMEDS) questionnaire. Participants report how often they took each prescribed secondary prevention medication during the preceding month, including antiplatelets, statins, beta-blockers, ACE inhibitors, or ARBs.
Responses use a 5-point scale:
1 = Less than half of the time, 2=About half of the time, 3=Most of the time, 4=Nearly all of the time, and 5=All of the time. Scores range from 1 to 5, with higher values indicating better adherence. For analysis, participants reporting "All of the time" for all prescribed secondary prevention medications will be classified as adherent; those reporting any other response for at least one medication will be classified as non-adherent. Results will be reported as proportions of adherent and non-adherent participants.
Measured: 1 year
Secondary outcomes (2)
Patient-reported barriers to medication adherence assessed using the My Experience of Taking Medicines (MYMEDS) questionnaire
Patient-reported barriers to medication adherence will be assessed using Sections 2-5 of the My Experience of Taking Medicines (MYMEDS) questionnaire. These sections assess understanding and satisfaction with medicines, concerns about medicines, practical difficulties with medication use, and difficulties fitting medicines into daily routines.
Each item is measured on a 4-point Likert scale: 1=Strongly disagree, 2=Disagree, 3=Agree, and 4=Strongly agree. Scores for individual items range from 1 to 4. Items will be analyzed separately rather than combined into a single overall score.
For barrier-related statements, higher scores indicate greater perceived barriers to medication adherence. For positively worded understanding and satisfaction statements, higher scores indicate greater understanding or satisfaction. Results will be summarized using frequencies and proportions for each item.
Measured: 1 year
Association between medication adherence and demographic and clinical factors
This outcome will assess the association between medication adherence status (adherent vs non-adherent) and patient demographic characteristics (age, sex, education level, occupation, place of residence, income) as well as clinical factors (type of ACS, comorbidities, and treatment received). This analysis aims to identify population subgroups at higher risk of non-adherence.
Measured: 1 year
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Dec 2025
- Study start1 Aug 2024
- Primary completion1 Aug 2025
- Study completion1 Aug 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Acute Coronary Syndromes (ACS)Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Other
- Time perspective
- Cross-sectional
- Enrolment
- 109 participants (actual)
Sponsor and investigators
- Lead sponsor
- Institute of medicine, Maharagjung medical campus
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Abhishek Kumar Shah, Institute of medicine, Maharagjung medical campus
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07288502
- Sponsor's protocol ID
- 290 (6-11) E2 081/ 082
- Status last verified
- Dec 2025
- First submitted
- 4 Dec 2025
- Last updated
- 2 Sep 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Individual participant data (IPD) will not be shared because the dataset contains sensitive clinical and sociodemographic information from a relatively small, identifiable group of ACS patients at a single tertiary centre, making robust de-identification difficult in the Nepali context. However, the aggregated findings, such as overall adherence pattern and analysis of demographic factors influencing adherence, will be presented in the final study report.