Jia?Rong Wu|Darren A. DeWalt|David W. Baker|Dean Schillinger|Bernice Ruo|Kirsten Bibbins?Domingo|Aurelia Macabasco?O’Connell|George M. Holmes|Kimberly A. Broucksou|Brian Erman|Victoria Hawk|Crystal W. Cené|Christine Jones|Michael Pignone
A single?item self?report medication adherence question predicts hospitalisation and death in patients with heart failure
University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|Northwestern University|San Francisco General Hospital|University of California, San Francisco|Northwestern University|San Francisco General Hospital|University of California, San Francisco|University of California, Los Angeles|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of Colorado Denver|University of North Carolina at Chapel Hill
aims objectives determine whether singleitem selfreport medication adherence question predicts hospitalisation death patients heart failure background poor medication adherence associated increased morbidity mortality simple means identifying suboptimal medication adherence could help identify atrisk patients interventions design performed prospective cohort study 592 participants heart failure within foursite randomised trial methods selfreport medication adherence assessed baseline using singleitem question past seven days many times miss dose heart medication participants reported missing doses defined fully adherent missing one dose considered less fully adherent primary outcome combined allcause hospitalisation death one year secondary endpoint heart failure hospitalisation outcomes assessed blinded chart reviews heart failure outcomes determined blinded adjudication committee used negative binomial regression examine relationship medication adherence outcomes results fiftytwo percent participants 52 male mean age 61 years 31 new york heart association class iii iv enrolment 72 participants reported full adherence heart medicine baseline participants full medication adherence lower rate allcause hospitalisation death 071 eventsyear compared nonadherence 086 eventsyear adjustedforsite incidence rate ratio 083 fully adjusted incidence rate ratio 068 incidence rate ratios similar heart failure hospitalisations conclusion single medication adherence question baseline predicts hospitalisation death one year heart failure patients relevance clinical practice medication adherence associated allcause heart failurerelated hospitalisation death heart failure important clinicians assess patients medication adherence regular basis clinical followups