Type D Personality Predicts Poor Medication Adherence in Patients with Heart Failure in the USA

Abstract

Background Type D (distressed) personality and medication nonadherence have been associated with poor health outcomes. Type D personality is associated with poor medication adherence in patients with coronary artery disease. However, the relationship between type D personality and medication adherence in patients with heart failure (HF) remains unknown. Purpose Therefore, the goal of this study was to examine the association between type D personality and medication adherence in patients with HF. Method This was a sub-analysis of baseline data from a randomized controlled trial with 84 patients with HF in the USA. Demographic, clinical, and psychological data were collected at baseline by interview, questionnaires, and medical record review. Type D personality was assessed using the Type D Personality Scale (DS14). Medication adherence was measured using both objective (Medication Event Monitoring System, MEMS) and self-reported (Morisky Medication Adherence Scale, MMAS-4) measures. Patients started medication adherence monitoring with the MEMS bottle at baseline and is used continuously for a month. Multiple regressions were used to explore the relationships between type D personality and medication adherence while adjusting for demographic, clinical, and psychological factors. Results Patients with type D personality were more likely to have poor medication adherence. Type D personality was associated with medication adherence before and after adjusting for covariates when it was analyzed as a categorical variable. However, type D personality was not associated with medication adherence when analyzed as a dimensional construct. Negative affectivity, a component of type D personality, was associated with medication adherence. Conclusion As a dimensional construct, type D personality may not reflect the components of the personality associated with poor outcomes. Negative affectivity was associated with medication adherence in patients with HF. Interventions aiming to improving/enhancing medication adherence need to take into account patients with the negative affectivity component of type D personality who are at higher risk for poor medication adherence, which may lead to adverse health outcomes.

Psychological Determinants of Heart Failure Self-Care

“…Two studies (81,82) of high quality consistently indicated that Type D personality was prospectively associated with decreased consulting behavior despite the increased tendency to perceive more cardiac symptoms and worrying about health (81), but these studies were based on the same cohort. Type D personality was also associated with poor objectively as well as subjectively measured medication adherence in another cohort in which negative affectivity seemed to drive this negative association and not necessarily the combination of negative affectivity and social inhibition (83). Hostility was associated with medication nonadherence in a study considered of high quality (41), but not with HF self-care in another large study (16).…”

Type D personality, self-efficacy, and medication adherence in patients with heart failure—A mediation analysis

“…18-20 To our knowledge, only four investigative groups have examined the relationship between Type D personality and medication adherence. 21-24 In these studies, Type D personality was associated with poor medication adherence in patients with myocardial infarction (MI), 22 acute coronary syndrome (ACS), 21 asthma, 23 and HF. 24 …”

D Tipo Asmenybių Su Implantuotu Elektrokardiostimuliatoriumi Gyvenimo Kokybės Aspektai

“…Pastebėta, kad D tipo asmenybės dažniau ir sunkiau serga šir-dies ir kraujagyslių ligomis (nestabilia krūtinės angina, miokardo infarktu, metaboliniu sindromu, hipertenzija, sunkiu širdies nepakankamumu), ankstesnės ir staigesnės jų mirtys nuo šių ligų [14][15][16]. D tipo asmenybę apibrėžia du psichologiniai komponentai: neigiamos emocijos (asmuo daž-nai jaučiasi nelaimingas, yra blogos nuotaikos, nerimauja, būna įsitempęs, nepasitiki kitais, abejoja, blogiau susitvarko su stresine situacija) ir socialinis varžymas (vengia bendrauti, klausti, aiškintis problemas, jaučiasi suvaržytas visuomenė-je, sunkiai kontaktuoja su žmonėmis, uždaro būdo).…”