Cognition, mood, self-care, and medication adherence in hospitalized patients with heart failure: a cross-sectional study

Poor medication adherence is prevalent in patients with heart failure (HF). Cognitive impairment (CI), mood (anxiety and depression), poor self-care are commonly seen and associated with medication adherence issues. However, it is not well established how these factors interact with each other impacting on HF patients' medication adherence. Therefore, the objective of this study was to determine relationships between cognition, mood, self-care and medication adherence of HF patients. We conducted a cross-sectional study and collected 200 hospitalized HF patients from Cardiology department of Linyi People's hospital in Shandong province, China. Cognition, mood, self-care and medication adherence were assessed by using Medication Adherence Self-Efficacy Scale-Revision (MASES-R), Montreal Cognitive Assessment (MoCA), Hospital Anxiety and Depression Scale (HADS) and Self-Care of Heart Failure Index version 7.2 (SCHFI v7.2), respectively. The results showed that the average score of MoCA, HADS, SCHFI, and MASES-R were 14.94 ± 8.13, 15.91 ± 12.46, 145.8 ± 67.5, 34.2 ± 14.0, respectively. Education, cognition, self-care were positively correlated with medication adherence. By comparison, sex, age, atrial fibrillation, NT-proBNP, duration of HF and mood (anxiety and depression) were negatively correlated with medication adherence. Mood and self-care had a direct impact on medication adherence. Cognition and self-care had an indirect impact on medication adherence through mood. Interventions should consider these interactions to improve medication adherence in the future.