TY - JOUR
T1 - Medication Non-Adherence After Myocardial Infarction
T2 - An Exploration of Modifying Factors
AU - Crowley, Matthew J.
AU - Zullig, Leah L.
AU - Shah, Bimal R.
AU - Shaw, Ryan J.
AU - Lindquist, Jennifer H.
AU - Peterson, Eric D.
AU - Bosworth, Hayden B.
N1 - Funding Information:
This study was supported in part by an award from the American Heart Association-Pharmaceutical Roundtable and David and Stevie Spina. Dr. Crowley is supported by a VA Health Services Research and Development Service Career Development Award (CDA 13-261), as is Dr. Zullig (CDA 13-025). Dr. Bosworth is supported by a Research Career Scientist award from the VA’s Health Services Research and Development (RCS 08-027), and has received honoraria from Takeda Pharmaceuticals, CVS/Caremark, and Sanofi Pharmaceuticals. Dr. Shah is a consultant for Castlight Health LLC, Janssen Pharmaceuticals, Cytokinetics, BMS, and Pfizer. Dr Peterson has received research grants from BMS/Sanofi, Merck/Schering, and Lilly. All other authors report no disclosures. These data have not been presented previously.
Publisher Copyright:
© 2014, Society of General Internal Medicine.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - 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.
AB - 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.
KW - cardiovascular disease
KW - health beliefs
KW - medication non-adherence
KW - psychosocial
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U2 - 10.1007/s11606-014-3072-x
DO - 10.1007/s11606-014-3072-x
M3 - Article
C2 - 25361685
AN - SCOPUS:84934957392
SN - 0884-8734
VL - 30
SP - 83
EP - 90
JO - Journal of general internal medicine
JF - Journal of general internal medicine
IS - 1
ER -