Document Type

Journal Article

Date of this Version

5-30-2012

Publication Source

Circulation: Heart Failure

Volume

5

Issue

4

Start Page

430

Last Page

436

DOI

10.1161/CIRCHEARTFAILURE.111.965152

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.

Copyright/Permission Statement

This is a non-final version of an article published in final form in Circulation: Quality & Outcomes, 2012, 5(1), 113-119. doi: 10.1161/CIRCOUTCOMES.111.962977.

Keywords

heart failure, medication adherence, patient compliance, self-care, sleep, World Health Organization

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Date Posted: 01 June 2016

This document has been peer reviewed.