Association Between Medication Adherence and the Outcomes of Heart Failure

Hood, Sarah R.; Giazzon, Anthony J.; Seamon, Gwen; Lane, Kathleen A.; Wang, Jane; Eckert, George J.; Tu, Wanzhu; Murray, Michael D.

doi:10.1002/phar.2107

Cited by 67 publications

(59 citation statements)

References 31 publications

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“…In the present study we have identified the non-adherence in 20 of 81 (25%) CHF patients. Compared to previous studies (5,6,8,9), the frequency of non-adherence was relatively low and the adherence to individual drug classes including diuretics and beta-blockers was relatively high in our study. We can only speculate about reasons.…”

Section: Discussioncontrasting

confidence: 93%

“…Non-adherence to prescribed medication has been reported in 11-60% CHF patients (3-10) as well as its negative effect on acute decompensations and mortality rate (3,5,6,(8)(9)(10). Finally, the negative economic impact of non-adherence to CHF medication has been also proven (23,24).…”

Section: Discussionmentioning

confidence: 99%

“…Life-saving pharmacological treatment based on Evidence based medicine remains the cornerstone of the care about CHF patients (2). Non-adherence to prescribed heart failure medication is common (3)(4)(5)(6)(7)(8)(9)(10) and is related to higher hospitalisations and mortality rate (3,5,6,(8)(9)(10). To verify drug adherence may be clinically important in order to make decisions on proper treatment strategy in still symptomatic CHF patients.…”

Section: Introductionmentioning

confidence: 99%

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The Assessment of Serum Drug Levels to Diagnose Non-Adherence in Stable Chronic Heart Failure Patients

Pelouch

Voříšek

Furmanová

et al. 2019

Acta Med. (Hradec Kralove, Czech Repub.)

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Background: The aim of our study was to evaluate the prevalence of drug non-adherence in stable chronic heart failure (CHF) patients using serum drug levels (SDL) assessment. Methods: CHF patients were prospectively enrolled during scheduled outpatient visit. Except standard procedures an unanticipated blood sampling for the SDL assessment was obtained. Analysis was focused on the prescribed heart failure and antihypertensive medication and was performed by liquid chromatography coupled with mass spectrometry. The patient was labelled as non-adherent if at least one of drugs assessed was not found in the serum. In the first half of patients multiple SDL have been evaluated during the follow-up. Results: Eighty one patients were enrolled. The non-adherence was proven in twenty of them (25%). In the subgroup of thirty eight patients with multiple SDL evaluation the non-adherence raised significantly with increasing number of visits assessed together (21% for single visit, 29% for two of three visits assessed together and 34% for all three visits evaluated together, all p < 0.001). Conclusion: The non-adherence was proven in significant part of stable CHF patients using SDL assessment. This method seems to be reliable and effective and should be a part of clinical assessment in selected patients with CHF.

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Section: Discussioncontrasting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Assessment of Serum Drug Levels to Diagnose Non-Adherence in Stable Chronic Heart Failure Patients

Pelouch

Voříšek

Furmanová

et al. 2019

Acta Med. (Hradec Kralove, Czech Repub.)

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“…The use of drugs in patients with coronary heart disease and heart failure is lifelong and continuous usage is needed. Results of some researches prove that the continuous usage of drugs in coronary heart disease and heart failure patients show signs of positive impact in clinical outcome of the patients and medical cost controlling 8,9 . Full-covered medical cost is one of the factors that give contribution to continuous usage of drugs in heart and blood vessel disorders 10 .…”

Section: Direct Medical Cost Analysis Among Coronary Heart Disease Anmentioning

confidence: 99%

Direct Medical Cost Analysis Among Coronary Heart Disease and Heart Failure Outpatients at One Hospital

Kumalasari

Rahem

Presley

et al. 2019

J. Manaj. dan Pelayanan Farm.

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Long-term treatment of cardiovascular disease may give impact in a high burden of medical cost for the patient. A concern arises whether the health budget allocation prepared by the Indonesian Government through "Jaminan Kesehatan Nasional" program is enough to cover medical cost for the outpatient treatment. This study aims to calculate the direct medical cost of patients with coronary heart disease and heart failure and compare it with the Indonesian Case Base Groups (INA-CBGs) tariff. This is a prospective and observational study carried out in one of the public hospitals in East Java between February and April 2015. All data related to outpatients with coronary heart disease and heart failure were analysed. Direct medical cost analysis in this study calculated from a combination of cost of medication, health professional services, electrocardiography, emergency care services, and laboratory test component, then it was compared with INA-CBGs tariff from ICD 10. Total of 390 patients included were 387 patients with coronary heart disease (99.23%) and three (3) patients with heart failure (0.77%). Average direct medical cost for patients with coronary heart disease and heart failure were IDR 130.593,6 (range IDR 50.282 – IDR 385.911) and IDR 128.587 (range IDR 112.832 – IDR 140.103), respectively. Even though this study showed that budget allocation of INA-CBGs could cover the average direct medical cost of patients with both of diseases, some patients had a direct medical cost higher than the limit of INA-CBGs allocation. Therefore, an optimal interprofessional collaboration between physician and pharmacist needed to provide medical treatment based on patient needs and keep it within budget allocation range.

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“…It's frequency is anticipated to increase in the future, especially in ageing populations (1) . Patients with HF are commonly prescribed multiple medications for which they have low treatment adherence, resulting in poor health outcomes (2) . Pharmacological agents such as beta blockers (BB), angiotensin converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB) and mineralocorticoid receptor antagonists (MRA) have proven to play an effective role in reducing the mortality related with HF.…”

Section: Introductionmentioning

confidence: 99%

Experiences of a University Hospital on Adhering to ESC Guidelines in Patients with Chronic Ischaemic Heart Failure

Oktay¹

2019

Kosuyolu Heart Journal

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Introduction: Ischaemic heart failure (HF) is a common public health problem that is associated with increased mortality, morbidity and medical costs. This study aimed to investigate the percentage of patients with HF who are taking target doses of the drugs to improve the mortality rate and assess the reasons for the patients' non-adherence to treatment guidelines during the follow-up period.Patients and Methods: Between January 2017 and December 2018, 480 patients who had been diagnosed with ST elevation myocardial infarction (STEMI) and had undergone primary percutaneous coronary intervention with a left ventricular ejection fraction (LVEF) of < 40% were enrolled in this study at our centre. The percentage of patients taking target doses of drugs that improved the mortality rate according to the 2016 European Society of Cardiology Guidelines for the treatment of HF, such as beta blockers (BB), angiotensin converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB) and mineralocorticoid receptor antagonists (MRA) at the time of discharge and at the 6-month follow-up period was investigated.Results: Of the 480 patients, the follow-up data of 430 patients were available and the percentages of patients prescribed with ACEI/ARB, BB and MRA at discharge were 86%, 89% and 28%, respectively. At the 6-month follow-up, the percentages of patients using ACEI/ARB, BB and MRA were 72%, 78% and 42%. About 7% of patients using BB switched to a different BB and 5% of the patients using ACEI were found to switch to an ARB. The percentages of patients taking target doses of ACEI/ARB, BB and MRA were 28%, 22% and 24%, respectively. Metoprolol succinate, ramipril and spironolactone were the most prescribed agents. Worsening of renal function, hyperkalaemia and bradycardia were the main reasons for non-achievement of target doses during the follow-up period. Conclusion:In clinical practice, the percentage of patients with ischaemic HF who were receiving optimal target doses of BB, ACEI and MRA was far below the desired levels as compared to the European Society of Cardiology (ESC) guidelines.

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Association Between Medication Adherence and the Outcomes of Heart Failure

Abstract: Incremental medication adherence was associated with reductions in emergency department visits, hospital admissions, length of hospital stay, and all-cause mortality.

Cited by 67 publications

References 31 publications

The Assessment of Serum Drug Levels to Diagnose Non-Adherence in Stable Chronic Heart Failure Patients

The Assessment of Serum Drug Levels to Diagnose Non-Adherence in Stable Chronic Heart Failure Patients

Direct Medical Cost Analysis Among Coronary Heart Disease and Heart Failure Outpatients at One Hospital

Experiences of a University Hospital on Adhering to ESC Guidelines in Patients with Chronic Ischaemic Heart Failure

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