Medication adherence among community-dwelling patients with heart failure

Shannon M Dunlay, Jessica M. Eveleth, Nilay D Shah, Sheila M. McNallan, Veronique Lee Roger

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE: To determine medication use and adherence among community-dwelling patients with heart failure (HF). PATIENTS AND METHODS: Residents of Olmsted County, Minnesota, with HF were recruited from October 10, 2007, through February 25, 2009. Pharmacy records were obtained for the 6 months after enrollment. Medication adherence was measured by the proportion of days covered (PDC). A PDC of less than 80% was classified as poor adherence. Factors associated with medication adherence were investigated. RESULTS: Among the 209 study patients with HF, 123 (59%) were male, and the mean ± SD age was 73.7±13.5 years. The median (interquartile range) number of unique medications filled during the 6-month study period was 11 (8-17). Patients with a documented medication allergy were excluded from eligibility for medication use within that medication class. Most patients received conventional HF therapy: 70% (147/209) were treated with β-blockers and 75% (149/200) with angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers. Most patients (62%; 127/205) also took statins. After exclusion of patients with missing dosage information, the proportion of those with poor adherence was 19% (27/140), 19% (28/144), and 13% (16/121) for β-blockers, angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, and statins, respectively. Self-reported data indicated that those with poor adherence experienced more cost-related medication issues. For example, those who adhered poorly to statin therapy more frequently reported stopping a prescription because of cost than those with good adherence (46% vs 6%; P<.001), skipping doses to save money (23% vs 3%; P=.03), and not filling a new prescription because of cost (46% vs 6%; P<.001). CONCLUSION: Community-dwelling patients with HF take a large number of medications. Medication adherence was suboptimal in many patients, often because of cost.

Original languageEnglish (US)
Pages (from-to)273-281
Number of pages9
JournalMayo Clinic Proceedings
Volume86
Issue number4
DOIs
StatePublished - 2011

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Independent Living
Medication Adherence
Heart Failure
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Costs and Cost Analysis
Angiotensin Receptor Antagonists
Angiotensin-Converting Enzyme Inhibitors
Prescriptions
Hypersensitivity

ASJC Scopus subject areas

  • Medicine(all)

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Medication adherence among community-dwelling patients with heart failure. / Dunlay, Shannon M; Eveleth, Jessica M.; Shah, Nilay D; McNallan, Sheila M.; Roger, Veronique Lee.

In: Mayo Clinic Proceedings, Vol. 86, No. 4, 2011, p. 273-281.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE: To determine medication use and adherence among community-dwelling patients with heart failure (HF). PATIENTS AND METHODS: Residents of Olmsted County, Minnesota, with HF were recruited from October 10, 2007, through February 25, 2009. Pharmacy records were obtained for the 6 months after enrollment. Medication adherence was measured by the proportion of days covered (PDC). A PDC of less than 80{\%} was classified as poor adherence. Factors associated with medication adherence were investigated. RESULTS: Among the 209 study patients with HF, 123 (59{\%}) were male, and the mean ± SD age was 73.7±13.5 years. The median (interquartile range) number of unique medications filled during the 6-month study period was 11 (8-17). Patients with a documented medication allergy were excluded from eligibility for medication use within that medication class. Most patients received conventional HF therapy: 70{\%} (147/209) were treated with β-blockers and 75{\%} (149/200) with angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers. Most patients (62{\%}; 127/205) also took statins. After exclusion of patients with missing dosage information, the proportion of those with poor adherence was 19{\%} (27/140), 19{\%} (28/144), and 13{\%} (16/121) for β-blockers, angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, and statins, respectively. Self-reported data indicated that those with poor adherence experienced more cost-related medication issues. For example, those who adhered poorly to statin therapy more frequently reported stopping a prescription because of cost than those with good adherence (46{\%} vs 6{\%}; P<.001), skipping doses to save money (23{\%} vs 3{\%}; P=.03), and not filling a new prescription because of cost (46{\%} vs 6{\%}; P<.001). CONCLUSION: Community-dwelling patients with HF take a large number of medications. Medication adherence was suboptimal in many patients, often because of cost.",
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N2 - OBJECTIVE: To determine medication use and adherence among community-dwelling patients with heart failure (HF). PATIENTS AND METHODS: Residents of Olmsted County, Minnesota, with HF were recruited from October 10, 2007, through February 25, 2009. Pharmacy records were obtained for the 6 months after enrollment. Medication adherence was measured by the proportion of days covered (PDC). A PDC of less than 80% was classified as poor adherence. Factors associated with medication adherence were investigated. RESULTS: Among the 209 study patients with HF, 123 (59%) were male, and the mean ± SD age was 73.7±13.5 years. The median (interquartile range) number of unique medications filled during the 6-month study period was 11 (8-17). Patients with a documented medication allergy were excluded from eligibility for medication use within that medication class. Most patients received conventional HF therapy: 70% (147/209) were treated with β-blockers and 75% (149/200) with angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers. Most patients (62%; 127/205) also took statins. After exclusion of patients with missing dosage information, the proportion of those with poor adherence was 19% (27/140), 19% (28/144), and 13% (16/121) for β-blockers, angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, and statins, respectively. Self-reported data indicated that those with poor adherence experienced more cost-related medication issues. For example, those who adhered poorly to statin therapy more frequently reported stopping a prescription because of cost than those with good adherence (46% vs 6%; P<.001), skipping doses to save money (23% vs 3%; P=.03), and not filling a new prescription because of cost (46% vs 6%; P<.001). CONCLUSION: Community-dwelling patients with HF take a large number of medications. Medication adherence was suboptimal in many patients, often because of cost.

AB - OBJECTIVE: To determine medication use and adherence among community-dwelling patients with heart failure (HF). PATIENTS AND METHODS: Residents of Olmsted County, Minnesota, with HF were recruited from October 10, 2007, through February 25, 2009. Pharmacy records were obtained for the 6 months after enrollment. Medication adherence was measured by the proportion of days covered (PDC). A PDC of less than 80% was classified as poor adherence. Factors associated with medication adherence were investigated. RESULTS: Among the 209 study patients with HF, 123 (59%) were male, and the mean ± SD age was 73.7±13.5 years. The median (interquartile range) number of unique medications filled during the 6-month study period was 11 (8-17). Patients with a documented medication allergy were excluded from eligibility for medication use within that medication class. Most patients received conventional HF therapy: 70% (147/209) were treated with β-blockers and 75% (149/200) with angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers. Most patients (62%; 127/205) also took statins. After exclusion of patients with missing dosage information, the proportion of those with poor adherence was 19% (27/140), 19% (28/144), and 13% (16/121) for β-blockers, angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, and statins, respectively. Self-reported data indicated that those with poor adherence experienced more cost-related medication issues. For example, those who adhered poorly to statin therapy more frequently reported stopping a prescription because of cost than those with good adherence (46% vs 6%; P<.001), skipping doses to save money (23% vs 3%; P=.03), and not filling a new prescription because of cost (46% vs 6%; P<.001). CONCLUSION: Community-dwelling patients with HF take a large number of medications. Medication adherence was suboptimal in many patients, often because of cost.

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