Barriers to medication adherence and links to cardiovascular disease risk factor control: the Framingham Heart Study

Hennein, Rachel; Hwang, Shih‐Jen; Au, Rhoda; Levy, Daniel; Muntner, Paul; Fox, Caroline S.; Ma, Jiantao

doi:10.1111/imj.13687

Cited by 52 publications

(44 citation statements)

References 43 publications

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“…Elevated depressive symptoms are associated with incident and exacerbated disability (Bruce, 2001) and falls (Hoffman, Hays, Wallace, Shapiro, & Ettner, 2017), so depressive symptoms may drive social security disability applications (Bilder & Mechanic, 2003), demands on caregivers (Langa et al, 2004), and healthcare utilization and cost (Luppa, Sikorski, Luck, et al, 2012). In addition, depressive symptoms relate to health outcomes and service utilization via poor disease management, such as lower adherence to medication (Hennein et al, 2018), dietary, and exercise regimens (Ciechanowski, Katon, Russo, & Hirsch, 2003; Gonzalez et al, 2008). Differences in depressive symptoms between subpopulations indicate that these consequences are disproportionately faced by those with low education and by racial/ethnic minorities—priority populations for designing and targeting prevention and treatment programs.…”

Section: Discussionmentioning

confidence: 99%

Changes in depressive symptoms over age among older Americans: Differences by gender, race/ethnicity, education, and birth cohort

Abrams

Mehta

2019

SSM - Population Health

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Despite concerns about recent trends in the health and functioning of older Americans, little is known about dynamics of depression among recent cohorts of U.S. older adults and how these dynamics differ across sociodemographic groups. This study examined sociodemographic differences in mid- and late-life depressive symptoms over age, as well as changes over time. Using nationally representative data from the Health and Retirement Study (1994–2014), we estimated mixed effects models to generate depressive symptoms over age by gender, race/ethnicity, education, and birth cohort in 33,280 adults ages 51–90 years. Depressive symptoms were measured using the 8-item Center for Epidemiological Studies Depression scale. Women compared to men, low compared to high education groups, and racial/ethnic minorities compared to whites exhibited higher depressive symptoms. The largest disparity resulted from education, with those without high school degrees exhibiting over two more predicted depressive symptoms in midlife compared to those with college degrees. Importantly, war babies and baby boomers (born 1942–1959) exhibited slightly higher depressive symptoms with more decreasing symptoms over age than their predecessors (born 1931–1941) at ages 51–65. We additionally observed an age- as -leveler pattern by gender, whereby females compared to males had higher depressive symptomology from ages 51–85, but not at ages 86–90. Our findings have implication for gauging the aging population's overall well-being, for public health policies aimed at reducing health disparities, and for anticipating demand on an array of health and social services.

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Section: Discussionmentioning

confidence: 99%

Changes in depressive symptoms over age among older Americans: Differences by gender, race/ethnicity, education, and birth cohort

Abrams

Mehta

2019

SSM - Population Health

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“…Medication adherence will be achieved with suitable dosage schedule. 24,25 The same principle is applicable in case if drugs are prescribed with more frequency like tid or qid. Patients may not take multiple tablets at one point.…”

Section: Split the Dosage Schedule In Case Of Multiple Drugs At Difmentioning

confidence: 99%

“…Considering the pharmacokinetics of the molecule may help in recommending drugs with longer duration of action and less frequency. 24,25…”

Section: Split the Dosage Schedule In Case Of Multiple Drugs At Difmentioning

confidence: 99%

Strengthening Medication Adherence Practices in Chronic Disease Patients-clinical Pharmacist Driven Focused Approach

Wadhwa¹,

Jalal²,

Merghani³

et al. 2019

IJOPP

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Medication adherence practices are becoming an important concern for healthcare professionals and patients. Globally, medication non-adherence is quite prevalent and affecting the healthcare of patients leading to inadequate response to treatment and augmented healthcare cost. With the advent of improvised practices in clinical care, patient-related problems mainly non-adherence have been conquered to a greater extent. Clinical practice is changing over a period contributing more towards patient care. Expansion of clinical pharmacy activities with a focused approach towards patient care especially optimized pharmaceutical care has seen a tremendous revolution in modern era. According to a study, 50% of patients with chronic conditions are not adherent to their medications with an estimated adherence range of 17% to 80%. Drugs used for asymptomatic chronic conditions have been shown to have low adherence rates. Risk of non-adherence has been shown to be rapidly increasing with the initiation of chronic medication especially in the first year of its commencement. Medication nonadherence is one of the most significant reason for inadequate response to drug therapy, initial hospitalization, frequent hospital visits and Adverse Drug Events (ADEs) leading to inappropriate therapeutic outcome and in turn, raised healthcare cost. Due to lack of sufficient support or appropriate channel, there is a growing concern for healthcare professionals to take initiative and strengthen the medication adherence practices. Clinical pharmacist's initiatives in this direction has been appreciated and documented with clinically proven evidence of better impact on patient's health-related quality of life. Patient tools such as pill reminders, alarming system, dose indicator, standard day-wise schedule, colorful pills etc. have brought pill revolution with the intention of improvising medication adherence practices worldwide. The current requirement is to monitor such patients in clinical practice and encourage them to comply with medication-related instructions and adhere to their medication schedule at the most.

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“…Although lifestyle risk factors of patients with high cardiovascular risk are monitored regularly as part of the risk-reducing programs, there is limited structural attention to medication adherence 1. This is startling because it is known that poor medication adherence is a major limitation in the secondary prevention of CVDs that may lead to increased morbidity, mortality, and costs 2–4. Approximately 50% of the patients using medication for a chronic disorder do not adhere to the prescribed drug regimen according to WHO 5.…”

Section: Introductionmentioning

confidence: 99%

<p>A nurse-based intervention for improving medication adherence in cardiovascular patients: an evaluation of a randomized controlled trial</p>

Sieben¹,

Onzenoort²,

Dulmen³

et al. 2019

PPA

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Background: Poor medication adherence is a limitation in the secondary prevention of cardiovascular diseases (CVDs) and leads to increased morbidity, mortality, and costs. Purpose: To examine the process and effect of a nurse-led, web-based intervention based on behavioral change strategies to improve medication adherence in patients with CVD. Patients and methods: In this single-center, prospective, controlled clinical trial, cardiovascular patients were assigned to usual care, usual care plus a personalized website, or usual care plus a personalized website and personal consultations. Primary outcome was the level of adherence to cardiovascular medication. Data collection occurred between October 2011 and January 2015. Results: In total, 419 patients were randomized. Just 77 patients logged on the website and half of the invited patients attended the group consultation. Due to the limited use of the website, we combined the results of usual care and the usual care plus website group in one group (usual care) and compared these with the results of the group which received the nurse intervention (intervention group). No significant difference in adherence between the usual care group and the intervention group was observed. The adherence level in the usual care group was 93%, compared to 89% in the intervention group ( p =0.08). 29% (usual care) and 31% (intervention group) of the patients showed a low adherence according to the Modified Morisky Scale® ( p -value=0.94). The mean necessity concern differential was 3.8 with no differences between the two studied groups (mean 3.8 vs mean 3.9, p -value =0.86). Conclusion: Our intervention program did not show an effect. This could indicate that structured usual care provided to all cardiovascular patients already results in high medication adherence or that shortly after a cardiovascular event adherence is high. It could also indicate that the program did not have enough impact because there was not enough compliance with the intervention protocol. Trial registration: ID number NCT01449695, approved May 2011.

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Barriers to medication adherence and links to cardiovascular disease risk factor control: the Framingham Heart Study

Abstract: Depressive symptoms might act as a barrier for medication adherence, which exacerbates CVD risk factors in older-aged adults.

Cited by 52 publications

References 43 publications

Changes in depressive symptoms over age among older Americans: Differences by gender, race/ethnicity, education, and birth cohort

Changes in depressive symptoms over age among older Americans: Differences by gender, race/ethnicity, education, and birth cohort

Strengthening Medication Adherence Practices in Chronic Disease Patients-clinical Pharmacist Driven Focused Approach

<p>A nurse-based intervention for improving medication adherence in cardiovascular patients: an evaluation of a randomized controlled trial</p>

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