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Medication adherence, compliance, satisfaction and health related quality of life after myocardial infarction: EMMACE 3 and 4 trials


Key facts

Type of research degree
4 year PhD
Application deadline
Ongoing deadline
Country eligibility
International (outside UK)
Professor Chris Gale and Dr Theresa Munyombwe
Additional supervisors
Bernadette Dondo, Teumzghi Mebrahtu
School of Medicine
Research groups/institutes
Leeds Institute of Cardiovascular and Metabolic Medicine
<h2 class="heading hide-accessible">Summary</h2>

Previous research has shown that patients with Myocardial Infarction (MI) experience decreased health related quality of life (HRQoL) compared to the general population (Lewis et al. 2014; Schweikert et al. 2008).

<h2 class="heading hide-accessible">Full description</h2>

<p>The American Heart Association recommends the inclusion of patient&rsquo;s HRQoL as an important measure of cardiovascular health among patients with cardiovascular disease (Rumsfeld et al. 2013). Medication adherence is necessary for effective therapy and there is evidence to suggest insufficient observed and self-reported adherence to medications (Krack et al. 2018). To improve adherence, its determinants need to be known.</p> <p>There are a few studies that have looked at the associations between medication adherence, patient satisfaction with medicines, and patient health related quality of life using longitudinal data. Therefore the aim of this project is to investigate associations of HRQoL, patient satisfaction with medicines, and medication adherence among AMI patients. We hypothesize that decreased HRQoL is associated with decreased medication adherence.</p> <p>Data sources:</p> <p>The project will use EMMACE 3 and 4 data. EMMACE-3 is a national, multi-centre, prospective, longitudinal cohort of patients hospitalised with Acute Coronary Syndrome (ACS) in England. 5556 patients were recruited between 1st November, 2011 and 17th September, 2013. Patient reported data at admission, 1 month, 6 months and 1 year follow-up comprised: Morisky Medication Adherence, Single Question Medicine Adherence, and Beliefs about Medicine, The Adherence Estimator and Problems with Taking medications, Satisfaction with Information about Medicines Scale, and EQ-5D. All patients were consented to enter the study and for their data to be linked to electronic health record data.</p> <p>EMMACE-4 is also a national, multi-centre, prospective, longitudinal cohort of patients hospitalised with ACS in England. 9343 patients were recruited between October 2013 to 24th June 2015. Patient reported outcome measures data at admission, 1 month, 6 months and 1 year follow-up comprised of Satisfaction with Information about Medicines Scale, List of Medications, Care Quality Commission Pickering Inpatient PROM, Brief Illness Perception, and EQ-5D.</p> <p>References:</p> <p>KRACK, G., R. HOLLE, I. KIRCHBERGER, B. KUCH, U. AMANN and H. SEIDL. 2018. Determinants of adherence and effects on health-related quality of life after myocardial infarction: a prospective cohort study. BMC geriatrics, 18(1), p136.</p> <p>LEWIS, E. F., Y. LI, M. A. PFEFFER, S. D. SOLOMON, K. P. WEINFURT, E. J. VELAZQUEZ, R. M. CALIFF, J.-L. ROULEAU, L. KOBER and H. D. WHITE. 2014. Impact of cardiovascular events on change in quality of life and utilities in patients after myocardial infarction: a VALIANT study (valsartan in acute myocardial infarction). JACC: Heart Failure, 2(2), pp.159-165.</p> <p>RUMSFELD, J. S., K. P. ALEXANDER, D. C. GOFF JR, M. M. GRAHAM, P. M. HO, F. A. MASOUDI, D. K. MOSER, V. L. ROGER, M. S. SLAUGHTER and K. G. SMOLDEREN. 2013. Cardiovascular health: the importance of measuring patient-reported health status: a scientific statement from the American Heart Association. Circulation, 127(22), pp.2233-2249.</p> <p>SCHWEIKERT, B., M. HUNGER, C. MEISINGER, H.-H. K&Ouml;NIG, O. GAPP and R. HOLLE. 2008. Quality of life several years after myocardial infarction: comparing the MONICA/KORA registry to the general population. European heart journal, 30(4), pp.436-443.</p>

<h2 class="heading">How to apply</h2>

<p>Please note these are not standalone projects and applicants must apply to the PhD academy directly.</p> <p>Applications can be made at any time. You should complete an <a href="">online application form</a> and attach the following documentation to support your application.&nbsp;</p> <ul> <li>a full academic CV</li> <li>degree certificate and transcripts of marks (or marks so far if still studying)</li> <li>Evidence that you meet the programme&rsquo;s minimum English language requirements (if applicable, see requirement below)</li> <li>Evidence of funding to support your studies</li> </ul> <p>To help us identify that you are applying for this project please ensure you provide the following information on your application form;</p> <ul> <li>Select PhD in Cardiovascular and Metabolic Disease as your programme of study</li> <li>Give the full project title and name the supervisors listed in this advert</li> </ul>

<h2 class="heading heading--sm">Entry requirements</h2>

A degree in biological sciences, dentistry, medicine, midwifery, nursing, psychology or a good honours degree in a subject relevant to the research topic. A Masters degree in a relevant subject may also be required in some areas of the Faculty. For entry requirements for all other research degrees we offer, please contact us.

<h2 class="heading heading--sm">English language requirements</h2>

Applicants whose first language is not English must provide evidence that their English language is sufficient to meet the specific demands of their study. The minimum requirements for this programme in IELTS and TOEFL tests are: &bull; British Council IELTS - score of 7.0 overall, with no element less than 6.5 &bull; TOEFL iBT - overall score of 100 with the listening and reading element no less than 22, writing element no less than 23 and the speaking element no less than 24.

<h2 class="heading">Contact details</h2>

<p>For further information please contact the Faculty Graduate School<br /> e:<a href=""></a></p>

<h3 class="heading heading--sm">Linked research areas</h3>