Results

A total of 385 patients were approached. After evaluating the results of the filled questionnaires,

it was found that most of the participants were females (50.1%), were below 65 years of age

(37.66%), living in urban areas (61.7%) and were married (68.0%). even though majority had a

higher education (59.2%), majority were unemployed (56.1%) and belonged to middle class

economic status (76.6%). With regards to level of illness perception, patients who were married

(56.1%), had no schooling to primary education (61.8%), were unemployed (51.9%) and those

suffering from myocardial infarction (57.7%) depicted a higher level of threatening illness

perception level (Table 1).

Table 1. Frequency distribution of sociodemographic variables with regards to Level of

Illness Perception
Demographics N (100%) Level of Illness Perception P-value
Low level Moderate High level
of level of of
threatenin threatening threatening
g illness illness illness
perception perception perception
Age (years) <65 240(62.3% 3 (1.3%) 121 (50.4%) 116 (48.3%) .687
)
>65 145 3 (2.1%) 68 (46.9%) 74 (51.0%)
(37.6%)
Gender Male 192 2 (1.0%) 104 (54.2%) 86 (44.8%) .118
(49.8%)
Female 193 4 (2.1%) 85 (44.0%) 104 (53.9%)
(50.1%)
Residence Rural 149 2 (1.3%) 75 (50.3%) 72 (48.3%) .904
(38.7%)
Urban 236 4 (1.7%) 114 (48.3%) 118 (50.0%)
(61.2%)
Marital Married 262 1 (0.4%) 114 (43.5%) 147 (56.1%) <.001
 Status (68.0%)
Unmarried 123 5 (4.1%) 75 (61.0%) 43 (35.0%)
(31.9%)
Educational No schooling 157 0 (0.0%) 60 (38.2%) 97 (61.8%) <.001
Status to primary (40.7%)
Secondary to 228 6 (2.6%) 129 (56.6%) 93 (40.8%)
higher (59.2%)
Employment Employed 169 3 (1.8%) 88 (52.1%) 78 (46.2%) .533
Status (43.8%)
Unemployed 216 3 (1.4%) 101 (46.8%) 112 (51.9%)
(56.1%)
Economic Low class 62 (16.1%) 0 (0.0%) 35 (56.5%) 27 (43.5%) .397
Status
Middle class 295 6 (2.0%) 138 (46.8%) 151 (51.2%)
(76.6%)
Upper class 28 (7.2%) 0 (0.0%) 16 (57.1%) 12 (42.9%)
Type of Angina 243 6 (2.5%) 129 (53.1%) 108 (44.4%) .012
Ischemic (63.1%)
Condition
Myocardial 142 0 (0.0%) 60 (42.3%) 82 (57.7%)
Infarction (36.8%)

Table 2. illustrates the level of adherence among the patients with different sociodemographic

variables. There was a significant difference in the level of adherence of both male and females

with more females showing non-adherence to therapy than males (p = 0.046). Also, patients who

were unmarried were more non-adherent (86.2%) as compared to those who were unmarried

(59.2%) (p <.001). Educational status also depicted a significant relationship with level of

adherence (p = 0.021). No significant association was observed of age, residence, employment

and economic status with level of adherence.

Table 2. Frequency distribution of socio-demographic variables with regards to medication
adherence.
Level of Adherence
Demographics N p-value
Adherent Non-Adherent

Age (years) <65 240 73 (30.4%) 167 (69.6%) .333

(62.3%)
>65 145 51(35.2%) 94 (64.8%)
(37.6%)
Gender Male 192 71 (37.0%) 121 (63.0%) .046
(49.8%)
Female 193 53 (27.5%) 140 (72.5%)
(50.1%)
Residence Rural 149 42 (28.2%) 107 (71.8%) .180
(38.7%)
Urban 236 82 (34.7%) 154 (65.3%)
(61.2%)
Marital Married 262 107 (40.8%) 155 (59.2%) <.001
Status (68.0%)
Unmarried 123 17 (13.8%) 106 (86.2%)
(31.9%)
Educational No schooling to primary 157 61 (38.9%) 96 (61.1%) .021
Status (40.7%)
Secondary to higher 228 63 (27.6%) 165 (72.4%)
(59.2%)
Employment Employed 169 63 (37.3%) 106 (62.7%) .060
Status (43.8%)
Unemployed 216 61 (28.2%) 155 (71.8%)
(56.1%)
Economic Low class 62 24 (38.7%) 38 (61.3%) .470
Status (16.1%)
Middle class 295 92 (31.2%) 203 (68.8%)
(76.6%)
Upper class 28 (7.2%) 8 (28.6%) 20 (71.4%)
 Type of Angina 243 77 (31.7%) 166 (68.3%) .775
Ischemic (63.1%)
Condition
Myocardial Infarction 142 47 (33.1%) 95 (66.9%)
(36.8%)

Table 3. shows the relationship between medication adherence and illness perception. A

significant association was observed (p = 0.019), depicting patients who had low level of

medication adherence, also had a high level of threatening illness perception level as well

(52.9%).

Table 3. Association of Level of Adherence with different Levels of Illness Perception.

Level of Level of illness perception P-value
Adherence Low level of Moderate level of High level of
threatening illness threatening illness threatening illness
perception perception perception
Adherent 0 (0.0%) 72 (58.1%) 52 (41.9%) 0.019
Non-adherent 6 (2.3%) 117 (44.8%) 138 (52.9%)
Discussion
Illness perception emerges out of our beliefs about illness and what illness means in the context

of our lives. A person might have her/his own thoughts about how an illness is caused, how long

it will last, how it will impact, and how it can be controlled or cured.

This study explains the two main factors that are illness perception and medication adherence. In

illness perception different parameters have been discussed like age, gender, residence, marital

status, economic status, educational status and also employment status. These parameters tell us

about the level of illness perception between counted patients according to their socio-

demographic variables. Our study explains that residence is not a major contributing factor

towards illness perception of IHD. Same case was with age, economic status and employment

status. However, marital and the educational status were the two main factors leading towards

the level of illness perception. It is also evident that knowledge makes the person to understand

things logically and makes better approach towards things.

A number of studies on illness perception have been conducted. Illness perceptions have been

found to be one of the factor determinants of behavior and have been associated with important

outcomes. There is a steady example to the way persons structure their perceptions of illness.

Illness perception generally contains an identity component, which includes the name of the

illness and the range of symptoms that the patient believes are associated with the condition.

They also contain beliefs about the cause of the illness and how long it will last. Furthermore,

illness perception components include beliefs about the consequences of the condition for the

patient and his/her family, as well as the extent to which the illness is amenable to control or to

control by treatment.(Nur, Chinnawong et al. 2017).

The second main parameter discussed here is the medication adherence which gives information

about number of patients who were adherent and non-adherent. In this scenario, same factors

were observed as discussed in illness perception. But in this case, gender, marital status,

educational and employment status are the significant factors in approach towards medication

adherence. Age, residence and economic factors are not major factors related towards medication

adherence.

In other studies, only 49.6% of people with ischemic heart disease adhere to the prescribed

medication. In our study, 32.1% people are adhere to medication. Others studies reported slightly

higher rates of adherence (66%). And still there were studies that had low rates, varying between

31-58% in adherence to prescribed cardioprotective medication (Dias, Pereira et al. 2014).

In other study  only 30% IHD patients exhibited adequate HL, out of which majority of them

were males, had secondary/higher secondary education, hailing from the middle class, employed

and were adherent to their medication.(Suhail, Saeed et al. 2021). In our study, 59.2% patients

were having secondary/higher education and out of them 27.6% were adherent to medication.

In another study, the adherence rate study was found to be 72%. This study has also shows that

the total amount of knowledge about the disease or medicines was higher in patients with

adherence to medicines (Karaeren, Yokuşoğlu et al. 2009).

Dias, A., et al. (2014). "Patients’ beliefs about medicines and adherence to medication in ischemic heart
disease." Atencion primaria 46: 101-106.

Karaeren, H., et al. (2009). "The effect of the content of the knowledge on adherence to medication in
hypertensive patients." Anatolian Journal of Cardiology/Anadolu Kardiyoloji Dergisi 9(3).

Nur, K. R. M., et al. (2017). "Illness perception and cardiovascular health behaviors in persons with
ischemic heart disease: a literature review." GSTF Journal of Nursing and Health Care (JNHC) 4(2).

Suhail, M., et al. (2021). "Association of health literacy and medication adherence with health-related
quality of life (HRQoL) in patients with ischemic heart disease." Health and Quality of Life Outcomes
19(1): 1-13.