Knowledge, Awareness, and Medication Adherence to Clopidogrel Therapy Among Patients in Zawiya, Libya: A Cross-Sectional Study
DOI:
https://doi.org/10.54361/LJMR.20.2.73Keywords:
Clopidogrel, medication adherence, patient awareness, bleeding risk, drug interactions, cross-sectional study, LibyaAbstract
Background: Clopidogrel is a widely used antiplatelet agent; however, its safe and effective use depends on patients’ knowledge, awareness, and adherence. Objective: This study aimed to assess patients’ knowledge, awareness, and adherence to clopidogrel therapy in Zawiya City, Libya, and to identify associated sociodemographic and clinical factors. Methods: A descriptive cross-sectional study was conducted among 150 clopidogrel users using a structured questionnaire covering knowledge, safety awareness, and medication practices. Data were analyzed using descriptive statistics and Chi-square tests. Results: Most participants were aware that clopidogrel prevents thrombotic events (70.0%) and increases bleeding risk (68.0%). However, important gaps were identified in awareness of drug interactions and peri-procedural precautions. Educational level was significantly associated with awareness of bleeding risk (p = 0.002) and current medication use (p = 0.032). Chronic disease status was significantly associated with awareness of analgesic interactions (p = 0.018) and consultation before analgesic use (p = 0.030). Age was significantly associated with consultation behaviour prior to painkiller use (p = 0.013).Conclusion: Although overall adherence was moderate, substantial deficiencies exist in patients’ safety-related knowledge. Targeted and structured educational interventions are needed to improve the safe use of clopidogrel.
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References
1. Byrne RA, Rossello X, Coughlan JJ, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023;44(38):3720-3826.
2. Lawton JS, Tamis-Holland JE, Bangalore S, et al. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization. Circulation. 2022;145:e18-e114.
3. Virani SS, Morris PB, Agarwala A, et al. 2023 AHA/ACC Guideline for the Management of Chronic Coronary Disease. Circulation. 2023.
4. Valgimigli M, Bueno H, Byrne RA, et al. Antiplatelet therapy recommendations in ACS: ESC update. Eur Heart J. 2023.
5. Raheem Z, Mohammed TR. Evaluation of Patients’ Knowledge and Adherence to Clopidogrel Therapy Post Percutaneous Coronary Intervention. Iraqi Nat J Nurs Spec. 2023;36(1):117-124.
6. Watanabe H, et al. Clopidogrel versus aspirin monotherapy beyond one year after PCI: 5-year outcomes. JAMA Cardiol. 2025.
7. Mehran R, Cao D, Angiolillo DJ, et al. Antiplatelet therapy after PCI in high bleeding risk patients. Lancet. 2023.
8. Collet JP, Thiele H, Barbato E, et al. 2020 ESC Guidelines for Acute Coronary Syndromes without ST-segment elevation. Eur Heart J. 2021;42:1289-1367.
9. Bhatt DL, Eikelboom JW, Connolly SJ, et al. Antithrombotic therapy for secondary prevention of cardiovascular disease. N Engl J Med. 2023.
10. Kumbhani DJ, Cannon CP, Beavers CJ, et al. Patient adherence to cardiovascular medications. J Am Coll Cardiol. 2022.
11. Angiolillo DJ, Rollini F. Clopidogrel pharmacology and clinical applications. Nat Rev Cardiol. 2022.
12. Arnett DK, Blumenthal RS, Albert MA, et al. Cardiovascular disease prevention recommendations. Circulation. 2022.
13. Maddox TM, Januzzi JL, Allen LA, et al. Clinical management and adherence in cardiovascular patients. JACC. 2023.
14. Nanna MG, Navar AM, Wang TY. Medication adherence and cardiovascular outcomes. Curr Cardiol Rep. 2022.
15. Khan SU, Lone AN, Khan MS, et al. Long-term antiplatelet therapy after myocardial infarction. Eur Heart J. 2022.
16. Vranckx P, Valgimigli M, Juni P. Dual antiplatelet therapy duration after PCI. Lancet. 2021.
17. Levine GN, Bates ER, Bittl JA, et al. Duration of dual antiplatelet therapy in coronary artery disease. Circulation. 2021 update.
18. Deharo P, Quilici J, Camoin-Jau L, et al. Predictors of clopidogrel adherence in cardiovascular patients. Thromb Haemost. 2022.
19. Yudi MB, Clark DJ, Farouque O, et al. Patient education and medication persistence after PCI. Heart Lung Circ. 2021.
20. Ho PM, Bryson CL, Rumsfeld JS. Medication adherence and cardiovascular outcomes. Circulation. 2009;119:3028-3035.
21. Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353:487-497.
22. Yusuf S, Zhao F, Mehta SR, et al. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes (CURE Trial). N Engl J Med. 2001;345:494-502.
23. CAPRIE Steering Committee. Clopidogrel versus aspirin in patients at risk of ischemic events. Lancet. 1996;348:1329-1339.
24. Mega JL, Close SL, Wiviott SD, et al. Cytochrome P450 polymorphisms and response to clopidogrel. N Engl J Med. 2009;360:354-362.
25. World Health Organization. Adherence to Long-Term Therapies: Evidence for Action. Geneva: WHO; 2023 update.
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