The close chronological proximity of this study to the procedure and the information given during phase I cardiac rehabilitation may make patients, at the time of recruitment into the study, more inclined to take medication. The sustainability of this adherence was not investigated as it was

outwith the scope of the research question. The cohort studied included patients who had undergone PCI electively or following an acute MI. Whether a patient had experienced an MI or they were having PCI electively may have augmented an increase in motivation to take medication. Those patients who had experienced an MI spoke of excruciating pain, as well as fear of subsequent events. The risk of stent thrombosis to patients from non-adherence with post-PCI medication is however the

same. Therefore, it is appropriate selleck kinase inhibitor to be indiscriminate with the selection of a post-PCI cohort. The qualitative results of the study are based on interviews with patients. It should be noted that quotations are thus based on accounts of events rather than on specific evidence of those events. Also, from a reflexive perspective, all participants in the study knew they were going to be interviewed by a pharmacist about their adherence to medication. Again, these factors may have influenced the study and the responses for participants. This was the first study to explore the patient-specific factors associated with medication adherence in a post-PCI cohort. However, patient adherence to the antiplatelet drug clopidogrel has been measured in check details two studies of post-PCI patients without characterising the reasons for such adherence. Firstly, Spertus et al. reported that one in seven post-MI patients with a stent stopped clopidogrel by 30 days, resulting in a significant increase in mortality over the next 11 months from 0.7 to 7.5% (P <  0.001).[19] No patients in the cohort studied in this research overtly stated the opinion that they would cease clopidogrel, except on the decision of a doctor. Secondly, Ho et al.

reported that discontinuation of clopidogrel increases risk of mortality in post-ACS patients with a stent from 6.9 to 19.9% (P < 0.001).[16] The risk of not being adherent with the post-PCI antiplatelet regimen is evidently potentially life-threatening. In light of the discovery for in this research, greater emphasis should be placed on the importance of aspirin, both by the healthcare professional and for the patient by means of appropriate education about the risks of death. The proportion of patients with high ABS and low NABS, suggestive of good adherence, was considerably higher than the 50% mean adherence rate for patients on medication for long-term conditions.[15] The results presented give an insight into patient-specific themes relating to adherence behaviour as well as quantifying that behaviour. For some patients the role of the community pharmacist was not well understood.