Key result
Lapses in attention (OR 2.65; P=0.023), excessive daytime sleepiness (OR 2.51; P=0.037), and ≥2 medication dosings per day (OR 2.59; P=0.016) predicted a steep decline in medication adherence.
Cohort (n=202)
Odds Ratio: 2.65
p-value: p=0.023
Lapses in attention, excessive daytime sleepiness, and multiple daily medication dosings are significant, potentially modifiable predictors of steep declines in medication adherence among heart failure patients.
May inform HF adherence support strategies; hypothesis-generating for targeted interventions.
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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Riegel et al. (2012) conducted a cohort in Heart failure (n=202). Lapses in attention vs. No lapses in attention was evaluated on Steep decline in medication adherence (adjusted OR 2.65, p=0.023). Lapses in attention (OR 2.65; P=0.023), excessive daytime sleepiness (OR 2.51; P=0.037), and ≥2 medication dosings per day (OR 2.59; P=0.016) predicted a steep decline in medication adherence.
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