2.3. Screening study and data collection
Screening followed a two-phase strategy to gather data on medication adherence. First, patients were asked to self-complete a questionnaire designed by the research team. This survey consisted of the Morisky Medication- Taking Adherence Scale (MMAS-4)34 and questions regarding demographic and identification data including age, ID number, sex, education level, place of residence (rural or urban), and body mass index. MMAS-4 license was obtained. Instructions on its filling were provided by a trained medical undergraduate. After questionnaire completion, a directed interview was conducted by the cardiology attending physician or resident of the institution in the office during the medical consultation to discern reasons for nonadherence. New York Heart Association (NYHA) Functional Classification was also determined at this point. Once the interview was completed, electronic medical records were reviewed to complete information on reperfusion therapy, the number of emergency visits and major cardiovascular events (MACE) in the last two years, along with the most recent laboratory findings including hemoglobin, creatinine, total cholesterol, triglycerides, and HbA1c levels.
Patients were randomly selected prior to appointments from the attending physician’s agenda to address potential bias. Electronic medical records were reviewed afterward to validate inclusion criteria fulfillment.
All data were recorded in predesigned files for data management and analysis by a research team member. Databases were encrypted in password-protected files, limiting their access to research staff only.