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. 2019 Jul/Aug;34(4):344-352.
doi: 10.1097/JCN.0000000000000582.

Factors Associated With Nonadherence to Cardiovascular Medications: A Cross-sectional Study

Danielle M van der Laan  1 , Petra J M Elders, Christel C L M Boons, Giel Nijpels, Jacqueline G Hugtenburg
Affiliations

Factors Associated With Nonadherence to Cardiovascular Medications: A Cross-sectional Study

Danielle M van der Laan et al. J Cardiovasc Nurs. 2019 Jul/Aug.

Abstract

Background: Cardiovascular medications have well-established benefits in the primary and secondary prevention of cardiovascular diseases. Unfortunately, adherence to these medicines is often suboptimal. To develop interventions intended to enhance adherence to cardiovascular medications, more insight is needed into the complex character of medication nonadherence.

Objective: The aim of the present study was to identify which factors are associated with nonadherence to cardiovascular medications in a sample of patients from Dutch community pharmacies.

Methods: In this cross-sectional study, patients using cardiovascular medications from 23 community pharmacies were included. Patient demographics, medication and disease characteristics, knowledge, quality of life, attitude toward medicines, and satisfaction with information were assessed. Both an adherent sample (n = 146) and a sample of patients nonadherent to prescribed medications (n = 109) during the last 6 months as assessed with pharmacy refill data (proportion of days covered <80%) were selected. Associations with refill nonadherence were assessed using univariate and multivariate logistic regression analyses.

Results: In total, 255 patients participated (53.3% men, 71.6 ± 10.9 years). Factors associated with cardiovascular medication nonadherence in multivariate analyses included experiencing difficulties with medication use due to forgetting, having insufficient knowledge on what to do when a dose is forgotten, and having an ambivalent attitude toward medicines (beliefs of high necessity and high concerns).

Conclusions: Intervention strategies to enhance cardiovascular medication nonadherence should be targeted mainly to the unintentional dimension of nonadherence and include information and tools to prevent forgetting. Conversely, the influence of factors that underlie intentional nonadherence, particularly patients' beliefs about medicines, should also be addressed.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

FIGURE
FIGURE
Participants flow diagram. SFK indicates Foundation for Pharmaceutical Statistics.
See this image and copyright information in PMC

References

    1. Nichols M, Townsend N, Scarborough P, Rayner M. Cardiovascular disease in Europe: epidemiological update. Eur Heart J. 2013;34(39):3028–3034. - PubMed
    1. Kronish IM, Ye S. Adherence to cardiovascular medications: lessons learned and future directions. Prog Cardiovasc Dis. 2013;55(6):590–600. - PMC - PubMed
    1. Ministerie Volksgezondheid en Zorg [Internet]. Volksgezondheidenzorg.info. https://www.volksgezondheidenzorg.info/onderwerp/hart-en-vaatziekten/cij.... Accessed December 31, 2018.
    1. Leening MJG, Siregar S, Vaartjes I, et al. Heart disease in the Netherlands: a quantitative update. Neth Heart J. 2014;22:3–10. - PMC - PubMed
    1. World Health Organization. Prevention of Cardiovascular Disease. Pocket Guidelines for Assessment and Management of Cardiovascular Risk. Geneva, Switzerland: World Health Organization; 2007.

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