BACKGROUND:Medication non-adherence is a major impediment to the management of cardiovascular disease risk factors. A better understanding of the modifying factors underlying medication non-adherence among individuals with known cardiovascular disease may inform approaches for addressing non-adherence. OBJECTIVE: The purpose of this study was to identify demographic and patient characteristics, medical comorbidities, psychosocial factors, and health belief-related factors associated with medication non-adherence among patients with known cardiovascular disease. DESIGN: We performed secondary analysis of baseline data from a randomized trial. PATIENTS: The study included 405 patients with a diagnosis of hypertension and history of acute myocardial infarction that was diagnosed within a three-year period prior to enrollment. MAIN MEASURES: Baseline demographics and patient characteristics, medical comorbidities, psychosocial factors, health belief-related factors, and patient-reported medication non-adherence were analyzed. KEY RESULTS: Of 405 patients, 173 (42.7 %) reported medication non-adherence. Factors associated with non-adherence in bivariate analysis included younger age, non-white race, having less than 12 years of education, smoking, financial insecurity, identifying as nervous or tense, higher life chaos score, greater worry about having a myocardial infarction, and greater worry about having a stroke. Using multivariable modeling, we determined that age (OR 0.97 per additional year, 95 % CI, 0.95-0.99), life chaos (OR 1.06 per additional point, 95 % CI, 1.00-1.11), and worry about stroke (OR 1.12 per additional point, 95 % CI, 1.01-1.25) remained significantly associated with self-reported medication non-adherence. CONCLUSIONS: We found that worry about having a stroke, higher life chaos, and younger age were all significantly associated with self-reported medication non-adherence in patients with cardiovascular disease and a history of myocardial infarction. Further research exploring these factors as targets for intervention is needed, as is additional research examining modifiable causes of medication non-adherence among patients with cardiovascular disease.
RCT Entities:
BACKGROUND: Medication non-adherence is a major impediment to the management of cardiovascular disease risk factors. A better understanding of the modifying factors underlying medication non-adherence among individuals with known cardiovascular disease may inform approaches for addressing non-adherence. OBJECTIVE: The purpose of this study was to identify demographic and patient characteristics, medical comorbidities, psychosocial factors, and health belief-related factors associated with medication non-adherence among patients with known cardiovascular disease. DESIGN: We performed secondary analysis of baseline data from a randomized trial. PATIENTS: The study included 405 patients with a diagnosis of hypertension and history of acute myocardial infarction that was diagnosed within a three-year period prior to enrollment. MAIN MEASURES: Baseline demographics and patient characteristics, medical comorbidities, psychosocial factors, health belief-related factors, and patient-reported medication non-adherence were analyzed. KEY RESULTS: Of 405 patients, 173 (42.7 %) reported medication non-adherence. Factors associated with non-adherence in bivariate analysis included younger age, non-white race, having less than 12 years of education, smoking, financial insecurity, identifying as nervous or tense, higher life chaos score, greater worry about having a myocardial infarction, and greater worry about having a stroke. Using multivariable modeling, we determined that age (OR 0.97 per additional year, 95 % CI, 0.95-0.99), life chaos (OR 1.06 per additional point, 95 % CI, 1.00-1.11), and worry about stroke (OR 1.12 per additional point, 95 % CI, 1.01-1.25) remained significantly associated with self-reported medication non-adherence. CONCLUSIONS: We found that worry about having a stroke, higher life chaos, and younger age were all significantly associated with self-reported medication non-adherence in patients with cardiovascular disease and a history of myocardial infarction. Further research exploring these factors as targets for intervention is needed, as is additional research examining modifiable causes of medication non-adherence among patients with cardiovascular disease.
Authors: L Kristin Newby; Nancy M Allen LaPointe; Anita Y Chen; Judith M Kramer; Bradley G Hammill; Elizabeth R DeLong; Lawrence H Muhlbaier; Robert M Califf Journal: Circulation Date: 2006-01-09 Impact factor: 29.690
Authors: P Michael Ho; David J Magid; Susan M Shetterly; Kari L Olson; Pamela N Peterson; Frederick A Masoudi; John S Rumsfeld Journal: Arch Intern Med Date: 2008-02-11
Authors: Fátima Rodriguez; Christopher P Cannon; Ph Gabriel Steg; Dharam J Kumbhani; Shinya Goto; Sidney C Smith; Kim A Eagle; E Magnus Ohman; Amarachi A Umez-Eronini; Elaine Hoffman; Deepak L Bhatt Journal: Clin Cardiol Date: 2013-10-25 Impact factor: 2.882
Authors: Rachel O'Conor; Julia Yoshino Benavente; Mary J Kwasny; Kamal Eldeirawi; Romana Hasnain-Wynia; Alex D Federman; Jennifer Hebert-Beirne; Michael S Wolf Journal: Gerontologist Date: 2019-09-17
Authors: Lucas N Marzec; Evan P Carey; Anne C Lambert-Kerzner; Eric J Del Giacco; Stephanie D Melnyk; Chris L Bryson; Ibrahim E Fahdi; Hayden B Bosworth; Fran Fiocchi; P Michael Ho Journal: Patient Prefer Adherence Date: 2015-06-08 Impact factor: 2.711
Authors: Keith C Ferdinand; Kapil Yadav; Samar A Nasser; Helene D Clayton-Jeter; John Lewin; Dennis R Cryer; Fortunato Fred Senatore Journal: J Clin Hypertens (Greenwich) Date: 2017-08-30 Impact factor: 3.738