Marie Krousel-Wood1,2,3, Erin Peacock1, Cara Joyce4, Shengxu Li2, Edward Frohlich3, Richard Re3, Katherine Mills2, Jing Chen1,2, Andrei Stefanescu2, Paul Whelton1,2, Gabriel Tajeu5, Ian Kronish6, Paul Muntner7. 1. Department of Medicine, School of Medicine. 2. Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University. 3. Ochsner Health System, New Orleans, Louisiana. 4. Departments of Public Health Sciences and Health Promotion, Loyola University Chicago, Chicago, Illinois. 5. Department of Health Services Administration and Policy, College of Public Health, Temple University, Philadelphia, Pennsylvania. 6. Department of Medicine, Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, New York. 7. Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Abstract
BACKGROUND: There is a need for a brief, open access, self-report medication adherence scale that overcomes challenges of existing adherence tools, is associated with incident cardiovascular disease (CVD), and identifies low 'implementation' adherers to antihypertensive medications to facilitate blood pressure management. METHODS AND RESULTS: Antihypertensive medication adherence was assessed in a cohort of 1532 older hypertensive adults without prior CVD using the self-report 4-item Krousel-Wood Medication Adherence Scale (K-Wood-MAS-4), a hybrid tool developed to predict pharmacy refill and which captures four domains of adherence behavior: self-efficacy, physical function, intentional medication-taking, and forgetfulness. The 4-item scale categorized participants as low and high adherers using scores at least 1 and less than 1, respectively. Participants were followed after K-Wood-MAS-4 assessment to identify incident CVD events (stroke, myocardial infarction, congestive heart failure, or CVD death). The prevalence of low adherence was 38.7%. During a median follow-up of 2.8 years (maximum 3.8 years), 136 (8.9%) participants had an incident CVD event; 12.8 and 6.4% in low and high adherers, respectively. The adjusted hazard ratio (aHR) for incident CVD associated with low versus high adherence was 2.29 [95% confidence interval (CI): 1.61, 3.26]. Results were similar when stratified by age [<75 years - aHR 3.53 (95% CI: 1.65, 7.56); ≥75 years - aHR 1.98 (95% CI: 1.32, 2.97)], sex [women - aHR 1.90 (95% CI: 1.16, 3.12); men - aHR 2.80 (95% CI: 1.68, 4.65)], and race [black - aHR 2.22 (95% CI: 0.93, 5.31); white - aHR 2.26 (95% CI: 1.54, 3.34)]. CONCLUSION: Low medication adherence using the 'hybrid' K-Wood-MAS-4 predicts incident CVD in a cohort of older adults with established hypertension.
BACKGROUND: There is a need for a brief, open access, self-report medication adherence scale that overcomes challenges of existing adherence tools, is associated with incident cardiovascular disease (CVD), and identifies low 'implementation' adherers to antihypertensive medications to facilitate blood pressure management. METHODS AND RESULTS: Antihypertensive medication adherence was assessed in a cohort of 1532 older hypertensive adults without prior CVD using the self-report 4-item Krousel-Wood Medication Adherence Scale (K-Wood-MAS-4), a hybrid tool developed to predict pharmacy refill and which captures four domains of adherence behavior: self-efficacy, physical function, intentional medication-taking, and forgetfulness. The 4-item scale categorized participants as low and high adherers using scores at least 1 and less than 1, respectively. Participants were followed after K-Wood-MAS-4 assessment to identify incident CVD events (stroke, myocardial infarction, congestive heart failure, or CVD death). The prevalence of low adherence was 38.7%. During a median follow-up of 2.8 years (maximum 3.8 years), 136 (8.9%) participants had an incident CVD event; 12.8 and 6.4% in low and high adherers, respectively. The adjusted hazard ratio (aHR) for incident CVD associated with low versus high adherence was 2.29 [95% confidence interval (CI): 1.61, 3.26]. Results were similar when stratified by age [<75 years - aHR 3.53 (95% CI: 1.65, 7.56); ≥75 years - aHR 1.98 (95% CI: 1.32, 2.97)], sex [women - aHR 1.90 (95% CI: 1.16, 3.12); men - aHR 2.80 (95% CI: 1.68, 4.65)], and race [black - aHR 2.22 (95% CI: 0.93, 5.31); white - aHR 2.26 (95% CI: 1.54, 3.34)]. CONCLUSION: Low medication adherence using the 'hybrid' K-Wood-MAS-4 predicts incident CVD in a cohort of older adults with established hypertension.
Authors: Cecile A Lengacher; Mary P Bennett; Kevin E Kipp; Adrienne Berarducci; Charles E Cox Journal: Oncol Nurs Forum Date: 2003 Sep-Oct Impact factor: 2.172
Authors: Aram V Chobanian; George L Bakris; Henry R Black; William C Cushman; Lee A Green; Joseph L Izzo; Daniel W Jones; Barry J Materson; Suzanne Oparil; Jackson T Wright; Edward J Roccella Journal: JAMA Date: 2003-05-14 Impact factor: 56.272
Authors: Diane E Bild; David A Bluemke; Gregory L Burke; Robert Detrano; Ana V Diez Roux; Aaron R Folsom; Philip Greenland; David R Jacob; Richard Kronmal; Kiang Liu; Jennifer Clark Nelson; Daniel O'Leary; Mohammed F Saad; Steven Shea; Moyses Szklo; Russell P Tracy Journal: Am J Epidemiol Date: 2002-11-01 Impact factor: 4.897
Authors: Marie Krousel-Wood; Erin Peacock; W David Bradford; Brice Mohundro; Leslie S Craig; Samantha O'Connell; Lydia Bazzano; Lizheng Shi; Milam Ford Journal: Am J Hypertens Date: 2022-03-08 Impact factor: 3.080
Authors: Leslie S Craig; Erin Peacock; Brice L Mohundro; Julia H Silver; James Marsh; Taylor C Johnson; P Adam Kelly; Lydia A Bazzano; Michael Cunningham; Richard E Petty; Marie Krousel-Wood Journal: J Am Heart Assoc Date: 2021-03-04 Impact factor: 5.501
Authors: Carolyn H Still; Seunghee P Margevicius; Jackson T Wright; Suebarn Ruksakulpiwat; Shirley M Moore Journal: J Prim Care Community Health Date: 2021 Jan-Dec
Authors: Olivia Nakwafila; Tivani Mashamba-Thompson; Anthony Godi; Benn Sartorius Journal: Int J Environ Res Public Health Date: 2022-04-06 Impact factor: 3.390
Authors: Erin Peacock; Cara Joyce; Leslie S Craig; Zachary Lenane; Elizabeth W Holt; Paul Muntner; Marie Krousel-Wood Journal: J Hypertens Date: 2021-01 Impact factor: 4.776