Document Detail


Predictors of objectively measured medication nonadherence in adults with heart failure.
MedLine Citation:
PMID:  22647773     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Medication nonadherence rates are high. The factors predicting nonadherence in heart failure remain unclear.
METHODS AND RESULTS: A sample of 202 adults with heart failure was enrolled from the northeastern United States and followed for 6 months. Specific aims were to describe the types of objectively measured medication adherence (eg, taking, timing, dosing, drug holidays) and to identify contributors to nonadherence 6 months after enrollment. Latent growth mixture modeling was used to identify distinct trajectories of adherence. Indicators of the 5 World Health Organization dimensions of adherence (socioeconomic, condition, therapy, patient, and healthcare system) were tested to identify contributors to nonadherence. Two distinct trajectories were identified and labeled persistent adherence (77.8%) and steep decline (22.3%). Three contributors to the steep decline in adherence were identified. Participants with lapses in attention (adjusted OR, 2.65; P=0.023), those with excessive daytime sleepiness (OR, 2.51; P=0.037), and those with ≥2 medication dosings per day (OR, 2.59; P=0.016) were more likely to have a steep decline in adherence over time than to have persistent adherence.
CONCLUSIONS: Two distinct patterns of adherence were identified. Three potentially modifiable contributors to nonadherence have been identified.
Authors:
Barbara Riegel; Christopher S Lee; Sarah J Ratcliffe; Sabina De Geest; Sheryl Potashnik; Megan Patey; Steven L Sayers; Lee R Goldberg; William S Weintraub
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2012-05-30
Journal Detail:
Title:  Circulation. Heart failure     Volume:  5     ISSN:  1941-3297     ISO Abbreviation:  Circ Heart Fail     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-19     Completed Date:  2012-09-25     Revised Date:  2014-07-07    
Medline Journal Info:
Nlm Unique ID:  101479941     Medline TA:  Circ Heart Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  430-6     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Attention
Cardiovascular Agents / administration & dosage*
Chi-Square Distribution
Disorders of Excessive Somnolence / epidemiology
Drug Administration Schedule
Female
Health Knowledge, Attitudes, Practice*
Heart Failure / drug therapy*,  epidemiology
Humans
Male
Medication Adherence*
Middle Aged
New England / epidemiology
Odds Ratio
Prospective Studies
Risk Assessment
Risk Factors
Self Care
Time Factors
Grant Support
ID/Acronym/Agency:
R01 HL084394/HL/NHLBI NIH HHS; R01 HL084394-01A1/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Cardiovascular Agents
Comments/Corrections

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