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e-Article

The influence of treatment decision on compliance with medication for patients with asymptomatic carotid artery stenosis – a cross-sectional study
Document Type
article
Source
Angiologia e Cirurgia Vascular, Vol 19, Iss 4 (2024)
Subject
Therapeutic Compliance
Best Medical Treatment
Endarterectomy
Asymptomatic
Carotid Artery Stenosis
Medicine
Diseases of the circulatory (Cardiovascular) system
RC666-701
Language
Portuguese
ISSN
1646-706X
2183-0096
Abstract
INTRODUCTION: Treatment decision in patients with asymptomatic carotid artery stenosis (ACS) is a matter of current debate with a recent shift towards isolated best medical treatment (BMT) as treatment of choice in most patients. However, poor medical compliance is one of the main constraints to the success of BMT. We hypothesized that more invasive treatment approaches can influence how patients perceive the severity of their illness and hence, treatment compliance. METHODS: A cross-sectional study was performed including patients with asymptomatic >50% carotid artery stenosis (NASCET method) followed-up as outpatients in a Vascular Surgery department from January 2017 to December 2021. Optimal BMT was defined according to the European Society of Vascular Surgery Carotid Atherosclerotic Disease 2023 guidelines. Demographic and risk factor patient data was attained and subsequently a Portuguese translation of the Morisky medication-taking adherence scale (MMAS-4) questionnaire was given to all patients. Several additional questions developed by our group were also applied. RESULTS: A total of 320 patients were identified (186 under BMT alone and 134 submitted to BMT and carotid endarterectomy - CEA). Most patients were male in both groups (75%) and the mean age was similar. Furthermore, patients undergoing CEA presented higher rates of current smoking (51.4% vs 15.9%; p