Predictors of objectively measured medication nonadherence in adults with heart failure

Barbara Riegel, Christopher S. Lee, Sarah J. Ratcliffe, Sabina De Geest, Sheryl Potashnik, Megan Patey, Steven L. Sayers, Lee R. Goldberg, William S. Weintraub

Research output: Contribution to journalArticle

36 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)430-436
Number of pages7
JournalCirculation: Heart Failure
Volume5
Issue number4
DOIs
StatePublished - Jul 2012

Keywords

  • Heart failure
  • Medication adherence
  • Patient compliance
  • Self-care
  • Sleep
  • World Health Organization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Riegel, B., Lee, C. S., Ratcliffe, S. J., De Geest, S., Potashnik, S., Patey, M., Sayers, S. L., Goldberg, L. R., & Weintraub, W. S. (2012). Predictors of objectively measured medication nonadherence in adults with heart failure. Circulation: Heart Failure, 5(4), 430-436. https://doi.org/10.1161/CIRCHEARTFAILURE.111.965152