TY - JOUR
T1 - Predictors of objectively measured medication nonadherence in adults with heart failure
AU - Riegel, Barbara
AU - Lee, Christopher S.
AU - Ratcliffe, Sarah J.
AU - De Geest, Sabina
AU - Potashnik, Sheryl
AU - Patey, Megan
AU - Sayers, Steven L.
AU - Goldberg, Lee R.
AU - Weintraub, William S.
PY - 2012/7
Y1 - 2012/7
N2 - 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.
AB - 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.
KW - Heart failure
KW - Medication adherence
KW - Patient compliance
KW - Self-care
KW - Sleep
KW - World Health Organization
UR - http://www.scopus.com/inward/record.url?scp=84864601818&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84864601818&partnerID=8YFLogxK
U2 - 10.1161/CIRCHEARTFAILURE.111.965152
DO - 10.1161/CIRCHEARTFAILURE.111.965152
M3 - Article
C2 - 22647773
AN - SCOPUS:84864601818
SN - 1941-3289
VL - 5
SP - 430
EP - 436
JO - Circulation: Heart Failure
JF - Circulation: Heart Failure
IS - 4
ER -