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Medication adherence to specific drug classes in chronic heart failure
Marta Viana1, Olga Laszczynska, Sandra Mendes
1Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas nº 135, 4050-600 Porto, Portugal. marta.viana@ispup.up.pt.
Journal of Managed Care & Specialty Pharmacy
|October 4, 2014
Summary
Heart failure patients show varying medication adherence across drug classes. Monitoring adherence to a single drug may misclassify overall patient behavior, impacting clinical outcomes.
Area of Science:
- Cardiology
- Pharmacology
- Health Outcomes Research
Background:
- Medication adherence is vital for heart failure (HF) patient outcomes.
- Nonadherence affects at least 25% of HF patients.
- Previous studies often monitored only one drug, potentially misrepresenting overall adherence.
Purpose of the Study:
- Quantify medication adherence to ACE inhibitors (ACEI), beta-blockers, and loop diuretics in HF patients.
- Compare adherence agreement across these distinct drug classes.
Main Methods:
- Medication adherence monitored using the Medication Event Monitoring System (MEMS) in 63 HF patients.
- Adherence defined as taking at least 88% of prescribed doses.
- Agreement analyzed using Bland-Altman plots and Kappa coefficients.
Main Results:
- Mean adherence: 97.3% for ACEI, 97.2% for beta-blockers, 96.0% for loop diuretics.
- Significant patient-level adherence differences observed across drug classes (range: -35% to 33%).
- Classifying adherence based on a single drug could misclassify 20% of patients.
Conclusions:
- Heart failure patients exhibit differential adherence to various medication classes.
- Lowest adherence observed for loop diuretics and beta-blockers; highest for ACE inhibitors.
- Future adherence studies must specify drug classes analyzed to avoid generalizing adherence behavior.
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