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Predictors of objectively measured medication nonadherence in adults with heart failure

, : Predictors of objectively measured medication nonadherence in adults with heart failure. Circulation. Heart Failure 5(4): 430-436

Medication nonadherence rates are high. The factors predicting nonadherence in heart failure remain unclear. and Results-A sample of 22 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=.23), those with excessive daytime sleepiness (OR, 2.51; P=.37), and those with ≥2 medication dosings per day (OR, 2.59; P=.16) were more likely to have a steep decline in adherence over time than to have persistent adherence. -Two distinct patterns of adherence were identified. Three potentially modifiable contributors to nonadherence have been identified.


PMID: 22647773

DOI: 10.1161/CIRCHEARTFAILURE.111.965152

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