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Multicenter Study
. 2012 Jul 1;5(4):430-6.
doi: 10.1161/CIRCHEARTFAILURE.111.965152. Epub 2012 May 30.

Predictors of objectively measured medication nonadherence in adults with heart failure

Barbara Riegel  1 , Christopher S Lee, Sarah J Ratcliffe, Sabina De Geest, Sheryl Potashnik, Megan Patey, Steven L Sayers, Lee R Goldberg, William S Weintraub
Affiliations
Multicenter Study

Predictors of objectively measured medication nonadherence in adults with heart failure

Barbara Riegel et al. Circ Heart Fail. .

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.

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Figures

Figure 1
Figure 1
Three Trajectories of Medication Adherence
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