Medication Nonadherence or Self-care? Understanding the Medication Decision-Making Process and Experiences of Older Adults With Heart Failure.
Rebecca Meraz
PMID 31567510WHAT IT FOUND
Older adults with heart failure described intentional medication changes triggered by symptoms, side effects, or lifestyle goals.
They did not see these changes as nonadherence, often avoided disclosure, and relied on the internet when clinicians were hard to reach.
Key findings
01Participants described intentional decisions to adjust, skip, or stop selected heart failure medications rather than forgetting them.
02Concerns about diuretic effects, including dehydration, urinary frequency, and public incontinence, commonly drove dose changes.
03Most participants could not easily reach clinicians, used the internet for medication information, and nearly all did not fully disclose medication changes.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 11 older adults from one region of the United States were studied, so the themes may not fit other patients. The interviews were retrospective stories about past medication decisions, which may include memory errors or bias. The study describes experiences and does not test any intervention, so it cannot show what improves adherence or outcomes.
The easy way to misread this
Do not read these findings as evidence that medication nonadherence is usually accidental or that an intervention would improve adherence. The study describes intentional decisions by 11 older adults and tested no treatment.