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Adherence to angiotensin-converting enzyme inhibitor therapy for heart failure
Patricia Bohachick1, Lora E Burke, Susan Sereika
1University of Pittsburgh School of Nursing, Pittsburgh, PA 15261, USA.
Insights
Heart failure patients showed high adherence to angiotensin-converting enzyme inhibitor therapy, averaging 84% over three months. Electronic monitoring identified patients needing adherence support.
Area of Science:
- Cardiology
- Pharmacology
- Health Services Research
Background:
- Heart failure management often involves complex medication regimens.
- Adherence to angiotensin-converting enzyme (ACE) inhibitor therapy is crucial for improving patient outcomes.
- Heart failure clinics are associated with better patient management and outcomes.
Purpose of the Study:
- To assess medication adherence to ACE inhibitor therapy in heart failure clinic patients.
- To evaluate the utility of electronic event monitoring in tracking adherence.
- To identify patient adherence patterns for targeted interventions.
Main Methods:
- A 3-month prospective study involving 171 heart failure clinic patients.
- Utilized electronic event monitors in medication bottle caps to record cap openings and closings.
- Calculated regimen adherence as the percentage of days the prescribed number of doses was taken.
Main Results:
- The average regimen adherence was 84% over the 3-month observation period.
- 71% of patients achieved 85%-100% adherence to their daily ACE inhibitor regimen.
- 19% of patients demonstrated less than 70% adherence, indicating poor adherence.
Conclusions:
- High adherence rates to ACE inhibitor therapy were observed in heart failure clinic patients.
- Electronic medication monitoring effectively identifies patients with suboptimal adherence.
- Targeted interventions are needed for poorly adherent patients to improve outcomes.
Abstract:
This study examined adherence to angiotensin-converting enzyme inhibitor therapy among 171 heart failure clinic patients. Adherence was monitored over a 3-month period with an electronic event monitor housed in a medication bottle cap, which recorded the date and time the cap was opened and closed. The average percentage of days that the prescribed number of doses (regimen adherence) was taken over the observation period was 84%. Seventy-one percent of patients showed 85%-100% adherence with their daily regimen; 19% exhibited less than 70% adherence. The overall high rates of adherence to angiotensin-converting enzyme inhibitor therapy observed among heart failure clinic patients is consistent with research that shows improved outcomes for patients managed in heart failure clinics. Electronic medication monitoring can be useful in identifying a substantial fraction of patients who are poorly adherent so that interventions to improve adherence can be targeted toward them. Additional research is needed to develop and test adherence-enhancing interventions.