cardiovascular-agents and Disorders-of-Excessive-Somnolence

Medication nonadherence rates are high. The factors predicting nonadherence in heart failure remain unclear.. 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.. Two distinct patterns of adherence were identified. Three potentially modifiable contributors to nonadherence have been identified.

Topics: Aged; Attention; Cardiovascular Agents; Chi-Square Distribution; Disorders of Excessive Somnolence; Drug Administration Schedule; Female; Health Knowledge, Attitudes, Practice; Heart Failure; Humans; Male; Medication Adherence; Middle Aged; New England; Odds Ratio; Prospective Studies; Risk Assessment; Risk Factors; Self Care; Time Factors