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Adherence and perception of medication in patients with chronic heart failure during a five-year randomised trial

Inger Ekman1, Gull Andersson, Kurt Boman

  • 1The Sahlgrenska Academy, Faculty of Health and Caring Sciences, Institute of Nursing, Göteborg University, Box 457, SE 405 30, Göteborg, Sweden. inger.ekman@fhs.gu.se

Patient Education and Counseling
|September 6, 2005
PubMed

Insights

Patient beliefs about medication significantly impact adherence in chronic heart failure (CHF). Understanding these perceptions is crucial for effective patient counseling and improving treatment outcomes in CHF patients.

Area of Science:

  • Cardiology
  • Clinical Pharmacy
  • Patient Adherence Research

Background:

  • Medication non-adherence is a significant challenge in managing chronic heart failure (CHF).
  • Understanding patient perceptions of medication is vital for improving adherence and treatment efficacy in CHF.
  • The Carvedilol or Metoprolol European Trial (COMET) provides a large dataset to investigate these factors.

Purpose of the Study:

  • To describe patient perceptions of regular and study medications.
  • To assess medication adherence at baseline and study end in CHF patients.
  • To identify factors influencing medication adherence and withdrawal in a clinical trial setting.

Main Methods:

  • Analysis of data from 3029 CHF patients in the COMET trial.
  • A sub-study involving a questionnaire administered at baseline and follow-up to assess medication perceptions.
  • Adherence estimation through drug usage analysis.

Main Results:

  • A high percentage of patients believed in the efficacy of both study and regular medications at baseline (94% and 82%, respectively).
  • Belief in regular cardiac medication significantly increased during the study.
  • Lack of belief in medication at baseline strongly predicted trial withdrawal (64% vs. 6.8%; p < 0.0001).
  • Patients with severe symptoms (NYHA III-IV) showed increased belief in regular medication but not study medication.

Conclusions:

  • Patient belief in medication is linked to perceived effects on functional ability, symptoms, and well-being.
  • Early identification of patient beliefs is essential for effective counseling and information delivery to CHF patients.
  • Addressing patient perceptions can potentially improve adherence and outcomes in chronic heart failure management.
Abstract

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