Methodology of an ongoing, randomized, controlled trial to improve drug use for elderly patients with chronic heart failure

Murray, Michael D.; Young, James; Morrow, Daniel G.; Weiner, Michael; Tu, Wanzhu; Hoke, Shawn; Clark, Daniel O.; Stroupe, Kevin T.; Wu, Jingwei; Deer, Melissa; Bruner-England, Tina E; Sowinski, Kevin M.; Smith, Frederick; Oldridge, Neil; Gradus‐Pizlo, Irmina; Murray, Laura L.; Brater, D. Craig; Weinberger, Morris

doi:10.1016/s1543-5946(04)90007-4

Cited by 56 publications

(39 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…First, as most others, we found that adherence was not optimal. [1][2][3][4][5][6][7] We also found, as others have reported, lower adherence in minorities, those with lower SES, multiple conditions, taking multiple drugs, and multiple dosing. 27,28 While five of the eight conditions studied found 75% of patients adherent (MPRs >0.80), higher than adherence rates reported by others, there remains room for improvement.…”

Section: Discussionsupporting

confidence: 85%

“…Several studies have been conducted examining medication adherence for various conditions, and adherence has consistently been found to be suboptimal. [1][2][3][4][5][6][7] Failure to take medication as prescribed increases the risk that patients will not get the intended benefit, often leading to negative sequelae. 3,[8][9][10][11][12] Further, not adhering to one's prescribed medications is likely to result in higher healthcare costs overall.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Patient Characteristics Associated with Medication Adherence

Rolnick

Pawloski

Hedblom

et al. 2013

Clinical Medicine & Research

383

294

View full text Add to dashboard Cite

Objective: Despite evidence indicating therapeutic benefit for adhering to a prescribed regimen, many patients do not take their medications as prescribed. Non-adherence often leads to morbidity and to higher health care costs. The objective of the study was to assess patient characteristics associated with medication adherence across eight diseases. Design:Retrospective data from a repository within an integrated health system was used to identify patients ≥18 years of age with ICD-9-CM codes for primary or secondary diagnoses for any of eight conditions (depression, hypertension, hyperlipidemia, diabetes, asthma or chronic obstructive pulmonary disease, multiple sclerosis, cancer, or osteoporosis). Electronic pharmacy data was then obtained for 128 medications used for treatment.Methods: Medication possession ratios (MPR) were calculated for those with one condition and one drug (n=15,334) and then for the total population having any of the eight diseases (n=31,636). The proportion of patients adherent (MPR ≥80%) was summarized by patient and living-area (census) characteristics. Bivariate associations between drug adherence and patient characteristics (age, sex, race, education, and comorbidity) were tested using contingency tables and chi-square tests. Logistic regression analysis examined predictors of adherence from patient and living area characteristics. Results:Medication adherence for those with one condition was higher in males, Caucasians, older patients, and those living in areas with higher education rates and higher income. In the total population, adherence increased with lower comorbidity and increased number of medications. Substantial variation in adherence was found by condition with the lowest adherence for diabetes (51%) and asthma (33%). Conclusions:The expectation of high adherence due to a covered pharmacy benefit, and to enhanced medication access did not hold. Differences in medication adherence were found across condition and by patient characteristics. Great room for improvement remains, specifically for diabetes and asthma.

show abstract

Section: Discussionsupporting

confidence: 85%

mentioning

confidence: 99%

Patient Characteristics Associated with Medication Adherence

Rolnick

Pawloski

Hedblom

et al. 2013

Clinical Medicine & Research

383

294

View full text Add to dashboard Cite

show abstract

“…Recruitment was through a Midwestern, county-managed urban hospital. 18 Most participants (95%) completed all measures reported in this article during baseline data collection for the intervention study (i.e., before random assignment to the intervention or usual care control groups of that study).…”

Section: Methodsmentioning

confidence: 99%

Cognition and Health Literacy in Patients with Hypertension

et al. 2008

Self Cite

View full text Add to dashboard Cite

show abstract

“…Recruitment was through a Midwestern, county-managed urban hospital (for details, see Murray, Young, et al, 2004). Participants completed all measures reported in this article during baseline data collection and before random assignment to intervention or usual care control groups in the adherence study.…”

Section: Methodsmentioning

confidence: 99%

Correlates of Health Literacy in Patients With Chronic Heart Failure

Morrow¹,

et al. 2006

Self Cite

View full text Add to dashboard Cite

Purpose: Many older adults have inadequate healthrelated literacy, which is associated with poor health outcomes. Thus, it is important to identify determinants of health literacy. We investigated relationships between health literacy and general cognitive and sensory abilities, as well as education, health, and demographic variables, in a community sample of middleaged and older adults. Design and Methods: Participants were 314 community-dwelling adults (67% female, 48% African American) diagnosed with chronic heart failure recruited for a pharmacist-based intervention study to improve adherence to chronic heart failure medications. We adminstered demographic, health, education, cognitive (e.g., processing speed, working memory), and sensory measures, and the Short Test of Functional Health Literacy in Adults (STOFHLA), as part of the baseline condition of this study. Results: STOFHLA scores were lower for participants who were older, less educated, male, African American, had more comorbidities, or scored lower on all cognitive ability measures. Hierarchical linear regression analyses showed that education and cognitive ability were independently associated with the STOFHLA measure and explained age differences in health literacy. Implications: The association of cognitive abilities and literacy has important implications for health literacy models and for interventions to reduce the impact of low health literacy on health outcomes. For example, medication instructions should be designed to reduce comprehension demands on general cognitive abilities as well as literacy skills.

show abstract

Methodology of an ongoing, randomized, controlled trial to improve drug use for elderly patients with chronic heart failure

Cited by 56 publications

References 34 publications

Patient Characteristics Associated with Medication Adherence

Patient Characteristics Associated with Medication Adherence

Cognition and Health Literacy in Patients with Hypertension

Correlates of Health Literacy in Patients With Chronic Heart Failure

Contact Info

Product

Resources

About