Risk factors for medication non-adherence among atrial fibrillation patients

BMC Cardiovascular Disorders

for the ATRIA-CVRN Investigators¹  Daniel E. Singer²  Teresa N. Harrison³  In-Lu Amy Liu³  Mary Helen Black³  Kristi Reynolds³  Stephanie R. Reading³  Rong X. Wei³  Margaret C. Fang⁴  Natalia Udaltsova⁵  Alan S. Go⁵ 

[1] ;Department of General Internal Medicine, Massachusetts General Hospital;Department of Research and Evaluation, Kaiser Permanente Southern California;Division of Hospital Medicine, University of California San Francisco;Division of Research, Kaiser Permanente Northern California;

关键词: Adherence;    Epidemiology;    Anticoagulants;    Warfarin;    Cardiology;   

DOI  :  10.1186/s12872-019-1019-1

来源: DOAJ

【 摘 要 】

Abstract Background Atrial fibrillation (AF) patients are routinely prescribed medications to prevent and treat complications, including those from common co-occurring comorbidities. However, adherence to such medications may be suboptimal. Therefore, we sought to identify risk factors for general medication non-adherence in a population of patients with atrial fibrillation. Methods Data were collected from a large, ethnically-diverse cohort of Kaiser Permanente Northern and Southern California adult members with incident diagnosed AF between January 1, 2006 and June 30, 2009. Self-reported questionnaires were completed between May 1, 2010 and September 30, 2010, assessing patient socio-demographics, health behaviors, health status, medical history and medication adherence. Medication adherence was assessed using a previously validated 3-item questionnaire. Medication non-adherence was defined as either taking medication(s) as the doctor prescribed 75% of the time or less, or forgetting or choosing to skip one or more medication(s) once per week or more. Electronic health records were used to obtain additional data on medical history. Multivariable logistic regression analyses examined the associations between patient characteristics and self-reported general medication adherence among patients with complete questionnaire data. Results Among 12,159 patients with complete questionnaire data, 6.3% (n = 771) reported medication non-adherence. Minority race/ethnicity versus non-Hispanic white, not married/with partner versus married/with partner, physical inactivity versus physically active, alcohol use versus no alcohol use, any days of self-reported poor physical health, mental health and/or sleep quality in the past 30 days versus 0 days, memory decline versus no memory decline, inadequate versus adequate health literacy, low-dose aspirin use versus no low-dose aspirin use, and diabetes mellitus were associated with higher adjusted odds of non-adherence, whereas, ages 65–84 years versus < 65 years of age, a Charlson Comorbidity Index score ≥ 3 versus 0, and hypertension were associated with lower adjusted odds of non-adherence. Conclusions Several potentially preventable and/or modifiable risk factors related to medication non-adherence and a few non-modifiable risk factors were identified. These risk factors should be considered when assessing medication adherence among patients diagnosed with AF.

【 授权许可】

Unknown