ORIGINAL ARTICLEMedication Adherence Among Community-Dwelling Patients With Heart Failure
Section snippets
PATIENTS AND METHODS
This is a population-based study conducted in Olmsted County, Minnesota, the estimated 2008 population of which was 141,360. Most residents are white (89%), and approximately 50% are female.13 This type of study is possible in this county because of the small number of medical providers, including Mayo Clinic, Olmsted Medical Center, and a few private practitioners. The records from each institution are indexed through the Rochester Epidemiology Project, a centralized data system that allows
RESULTS
Between October 10, 2007, and February 25, 2009, 402 patients with HF were approached for enrollment, and 245 (61%) consented to the pharmacy portion of the study. We could not obtain all pharmacy records for 25 patients, 8 were nursing home residents, and 3 did not speak English, resulting in a final study population of 209. The population was older, with a mean ± SD age of 73.7±13.5 years; 123 (59%) were male, 93 (48%) had a preserved EF, and comorbid conditions such as hypertension and
DISCUSSION
Community-dwelling patients with HF are commonly required to take a large number of prescription medications, and over half take at least 1 medication 3 times daily. Overall, 13% to 20% of patients with HF exhibit poor adherence to conventional HF medications. Cost is a notable barrier to adherence.
CONCLUSION
Community-dwelling patients with HF take a substantial number of medications, often several times a day. Use of β-blockers, ACEIs or ARBs, loop diuretics, and statins was common among patients with both preserved and reduced EF. Medication adherence was suboptimal in many patients, and those with poor adherence were more likely to report cost-related medication issues. Further work is needed to determine the effect of interventions to improve medication adherence among patients with HF. Efforts
Acknowledgments
We thank Kay Traverse, RN, Annette McNallan, RN, and Amy Wagie, BS, for their study support.
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This study was supported by grants from the National Institutes of Health (RO1HL72435, T32 HL07111-31A1) and was made possible by the Rochester Epidemiology Project (AG034676, National Institute on Aging).
An earlier version of this article appeared Online First.