Medication Nonadherence Before Hospitalization for Acute Cardiac Events

Kripalani, Sunil; Goggins, Kathryn; Nwosu, Sam; Schildcrout, Jonathan S.; Mixon, Amanda S.; McNaughton, Candace D.; Scott, Amanda M.; Wallston, Kenneth A.

doi:10.1080/10810730.2015.1080331

Cited by 46 publications

(44 citation statements)

References 57 publications

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“…Low health literacy even though has been previously found to be a mediator of adverse outcomes 44 and of self-reported adherence 39 was not significant in multivariate models that used a categorical objective measure of adherence. This may suggest a confounding effect with the other factors or lack of discriminatory ability when using a dichotomized MPR, since the health literacy effect was significant when the continuous MPR measure was used.…”

Section: Discussionmentioning

confidence: 64%

“…However, the literature has been mixed regarding the association between adherence to medications and depressive symptoms and it seems to vary according to disease state. Nevertheless, depression has been a consistent predictor of adherence among diabetic patients 33 and more recently among subjects hospitalized with acute cardiac events 39 .…”

Section: Discussionmentioning

confidence: 99%

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Can We Identify Minority Patients at Risk of Nonadherence to Antiplatelet Medication at the Time of Coronary Stent Placement?

Palacio¹,

Vidot²,

Tamariz³

et al. 2017

J Cardiovasc Nurs

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Background Lack of medication adherence is associated with significant morbidity and mortality, particularly among minorities. We aimed to identify predictors of non-adherence to antiplatelet medications at the time of percutaneous coronary intervention (PCI) with stent among African American and Hispanic subjects. Methods We used data collected for a randomized clinical trial that recruited 452 minority subjects from a large U.S. health insurance organization in 2010 post-PCI to compare phone-based motivational interviewing by trained nurses (MINT) to an educational video. The primary outcome was 12-month adherence to antiplatelet medications measured by the claims-based medication possession ratio (MPR). Adequate adherence was defined as MPR>=0.80. Results Over half of sample (age 69.52 ± 8.8 years) was male (57%) and Hispanic (57%). Majority (78%) had a median income below $30,000 and 22% completed high school or higher. Univariate analyses revealed that symptoms of depression (<0.01) and not having a spouse (p=0.03) were associated with inadequate adherence. In multivariate analysis, baseline self-reported adherence (1.4; 95% confidence interval [CI] 1.05–1.89), depressive symptoms (0.49; 95% CI 0.7–0.90), comorbidity (0.89; 95% CI 0.80–0.98) and MINT (3.5; 95% CI 1.9–2.70) were associated with adherence. Conclusions Having multiple comorbidities, depression, suboptimal adherence to medications, and low English proficiency at the time of PCI increase the risk of poor 12-month adherence to antiplatelets among minorities. Identifying these risk factors can guide PCI therapy and the use of evidence-based strategies to improve long-term adherence.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Can We Identify Minority Patients at Risk of Nonadherence to Antiplatelet Medication at the Time of Coronary Stent Placement?

Palacio¹,

Vidot²,

Tamariz³

et al. 2017

J Cardiovasc Nurs

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“…[33][34][35][36] We also found that adults who had a usual source of care, were married, and had higher education had greater odds of statin use, which is consistent with prior research. [37][38][39][40] Understanding barriers to statin use-including patient, clinician, and delivery system factors as well as costs-is important when identifying strategies to improve quality of care. Statins are now available to many Americans at little-to-no out-ofpocket cost regardless of whether they are being used for primary or secondary prevention.…”

Section: Discussionmentioning

confidence: 99%

Statin Use in the U.S. for Secondary Prevention of Cardiovascular Disease Remains Suboptimal

et al. 2019

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Background: Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of mortality in the United States. The purpose of this study is to examine the rates of statin use for secondary prevention of ASCVD events in the United States over the last decade and determine whether disparities in the treatment of ASCVD still persist among women and racial/ethnic minorities. Methods: We conducted a trend analysis using data from 2008 through 2016 to describe age-adjusted trends in the use of statins for secondary prevention using the Medical Expenditure Panel Survey. We also conducted a multivariable logistic regression analysis to determine whether sociodemographic characteristics are associated with statin use during the 3 years that followed the publication of the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline (2014 through 2016). Results: The prevalence of statin use among those with a history of ASCVD remained unchanged from 2008 through 2016. In 2014 to 2016, more than 40% of those aged 40 years and older with a history of ASCVD did not use statins, corresponding to approximately 9.5 million Americans. Increasing age and having been diagnosed with high cholesterol (odds ratio [OR], 6.22; P < .001) were associated with higher odds of statin use while being female (OR, 0.65; P < .001) or Hispanic (OR, 0.69; P ‫؍‬ .011) were associated with lower odds of statin use. Conclusions: Our study found there was no increase in the national rates of statin use following the ACC/AHA 2013 secondary prevention guideline and the availability of generic statins. Significant gender and ethnic disparities in ASCVD treatment remained in the United States.

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“…In addition to oral health, self‐efficacy is related to a range of other general health behaviours and measures. Perceived health competence has been associated with physical activity among cancer patients , and health competence has been related to medication non‐adherence among adults hospitalized for cardiovascular disease . Perceived health competence and social support have been reported to buffer the negative effects of post‐discharge stress that may occur following hospitalization for cardiac disease .…”

Section: Discussionmentioning

confidence: 99%

Psychosocial factors and self‐reported transitions in oral and general health

Brennan¹,

Mittinty²,

Jamieson³

2019

European J Oral Sciences

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Psychosocial factors may explain variance in health beyond conventional indicators, such as behaviours. This study aimed to examine changes in health associated with perceived stress, social support, and self‐efficacy, controlling for sociodemographic characteristics and health behaviour. A random sample of 45‐ to 54‐yr‐old subjects was surveyed in 2004–2005, with a follow‐up 2 yr later. The outcomes were self‐reported changes in oral and general health. Explanatory variables included stress, social support, and perceived health competence with covariates of income, gender, dentition status, toothbrushing, and smoking. Responses were collected from 986 persons (response = 44.4%). At the 2‐yr follow‐up, 25.6% reported worsening in oral health and 15.3% reported worsening in general health. Prevalence ratios (PR) from adjusted log‐binomial regression showed an association between worsening oral health and higher perceived health competence (PR = 0.75, 95% CI: 0.57–0.99), and worsening general health was associated with perceived health competence (PR = 0.82, 95% CI: 0.72–0.94) and stress (PR = 1.17, 95% CI: 1.03–1.32). Worsening oral and general health were seen for male subjects (PR = 1.33, 95% CI: 1.06–1.68 and PR = 1.14, 95% CI: 1.01–1.29) and low income (PR = 1.40, 95% CI: 1.04–1.89 and PR = 1.20, 95% CI: 1.03–1.40). Health‐related self‐efficacy representing psychosocial resilience was associated with oral and general health, while stress was associated with general health. Psychosocial factors were independent predictors of change in health after controlling for sociodemographic characteristics and health behaviours.

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Medication Nonadherence Before Hospitalization for Acute Cardiac Events

Cited by 46 publications

References 57 publications

Can We Identify Minority Patients at Risk of Nonadherence to Antiplatelet Medication at the Time of Coronary Stent Placement?

Can We Identify Minority Patients at Risk of Nonadherence to Antiplatelet Medication at the Time of Coronary Stent Placement?

Statin Use in the U.S. for Secondary Prevention of Cardiovascular Disease Remains Suboptimal

Psychosocial factors and self‐reported transitions in oral and general health

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