Predictors of Objectively Measured Medication Nonadherence in Adults with Heart Failure.
Circ Heart Fail. 2012 May 30;
Authors: Riegel B, Lee CS, Ratcliffe SJ, De Geest S, Potashnik S, Patey M, Sayers SL, Goldberg LR, Weintraub WS
BACKGROUND: -Medication nonadherence rates are high. The factors predicting nonadherence in heart failure (HF) remain unclear. METHODS AND RESULTS: -A sample of 202 adults with HF was enrolled from the Northeastern U.S. and followed for 6 months. Specific aims were to describe the types of objectively measured medication nonadherence (e.g. taking, timing, dosing, drug holidays) and to identify contributors to nonadherence 6 months after enrollment. Latent growth mixture modeling (GMM) was used to identify distinct trajectories of adherence. Indicators of the five World Health Organization (WHO) dimensions of adherence (socioeconomic, condition, therapy, patient, and health care 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 odds ratio (OR) = 2.65, p=0.023), those with excessive daytime sleepiness (OR = 2.51, p=0.037), and those with two or more 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.
PMID: 22647773 [PubMed - as supplied by publisher]