Alejandra P. Granda-Lazo, Facultad de Medicina Humana, Universidad César Vallejo, Piura, Perú
Víctor A. Contreras-Guerrero, Facultad de Medicina Humana, Universidad Ricardo Palma, Lima, Perú
Background: Adherence to clinical practice guidelines (CPGs) for acute myocardial infarction (AMI) is a key indicator of healthcare quality and is associated with improved clinical outcomes. However, adherence may vary according to demographic and clinical characteristics. Objectives: To determine the association of demographic factors (age and sex) and clinical factors (hypertension, diabetes mellitus, and chronic kidney disease) with adherence to CPGs among patients with AMI treated in the Emergency Department of Ramiro Prialé Prado National Hospital during 2022-2023. Methods: An observational, retrospective, analytical, cross-sectional study was conducted. Adult patients diagnosed with AMI and treated in the emergency department were included. Adherence was assessed using a data collection form based on the EsSalud clinical practice guideline for acute coronary syndrome, comprising 17 indicators covering initial management, treatment, and timeliness of care. Overall adherence was classified as adequate, partially adequate, or inadequate. Results: A total of 113 patients were analyzed. Overall adherence was adequate in 62.8% of patients, partially adequate in 36.3%, and inadequate in 0.9%. Initial and therapeutic management was adequate in 87.6% of cases, whereas adherence to time-dependent indicators reached only 30.1%. Most patients were older adults (68.1%) and male (85.8%). Sex was the only variable significantly associated with guideline adherence (p = 0.033). Conclusions: Overall adherence to the CPG for AMI was predominantly adequate; however, important gaps remained in time-dependent care indicators. Strengthening healthcare processes and investigating contextual barriers may improve adherence to guideline recommendations.
Keywords: Treatment adherence and compliance. Myocardial infarction. Hypertension. Chronic kidney disease. Diabetes mellitus.
