Factors Associated With Nonadherence to Cardiovascular Medications: A Cross-sectional Study.
Danielle M van der Laan, Petra J M Elders, Christel C L M Boons and 2 others
PMID 31045696WHAT IT FOUND
Patients who forgot doses or didn't know what to do when they missed a pill were much more likely to be nonadherent.
Those with ambivalent feelings about their medicines were also at higher risk. Clinicians should explicitly teach missed-dose protocols.
Key findings
01In multivariate analysis, patients who reported difficulties with medication use due to forgetting were significantly more likely to be nonadherent (OR, 3.16).
02Patients with insufficient self-reported knowledge on what to do when a dose is forgotten had significantly higher odds of nonadherence (OR, 2.80).
03Having an ambivalent attitude toward medicines (high necessity, high concerns) was significantly associated with nonadherence compared to accepting attitudes (OR, 2.26).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study used a purposive sampling method to create equal groups of adherent and nonadherent patients, so the results cannot be used to estimate the true prevalence of nonadherence in the general population. Adherence was measured by pharmacy refill data, which does not confirm that patients actually took the medication once dispensed. Some questionnaire items were self-composed by the research team and had unclear validity and reproducibility. The cross-sectional design prevents determining causality; it is unclear if forgetting causes nonadherence or if nonadherent patients are more likely to report forgetting.
Declared interests
The authors declared no conflicts of interest. The study was not funded by a commercial entity.
The easy way to misread this
Do not assume this study shows that older age or complex regimens are primary drivers of nonadherence. While older age was associated in univariate analysis, it did not remain significant in the multivariate model. The strongest predictors were specific knowledge gaps about missed doses and patient ambivalence about their medicines.