Lucas Marzec|Evan Carey|Anne Lambert?Kerzner|Eric J. Del Giacco|S. Dee Melnyk|Chris L. Bryson|Ibrahim E. Fahdi|Hayden B. Bosworth|Fran Fiocchi|P. Michael Ho
Cognitive dysfunction and poor health literacy are common in veterans presenting with acute coronary syndrome: insights from the MEDICATION study
Denver VA Medical Center|Denver VA Medical Center|Denver VA Medical Center|University of Arkansas Medical Center|Durham VA Medical Center|VA Puget Sound Health Care System|University of Arkansas Medical Center|Durham VA Medical Center|American College of Cardiology|Denver VA Medical Center
patient nonadherence cardiac medications following acute coronary syndrome acs associated increased risk recurrent events however prevalence cognitive dysfunction poor health literacy among acs patients association medication nonadherence poorly understoodwe assessed rates cognitive dysfunction poor health literacy among participants clinical trial tested effectiveness intervention improve medication adherence patients hospitalized acs 254 patients 249 completed rapid estimate adult literacy medicine revised realmr survey assessment risk poor literacy st louis university mental status slums exam tool assessing neurocognitive deficits acs hospitalization assessed slums realmr scores associated medication adherencebased slums score 14 patients categorized dementia 52 mild neurocognitive disorder mncd based realmr score 6 34 patients categorized risk poor health literacy association poor health literacy medication nonadherence mncd 355 nonadherent compared 175 normal cognitive function 67 dementia multivariable analysis cognitive dysfunction associated medication nonadherence p0007 mainly due association mncd nonadherence odds ratio 122 95 confidence interval 19 243 p0007 cognitive status associated adherence patients randomized interventioncognitive dysfunction risk poor health literacy common patients hospitalized acs found association mncd medication nonadherence usual care group intervention group findings suggest efforts screen mncd needed acs hospitalization identify patients risk nonadherence may benefit adherence intervention