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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
PubMed

Insights

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.
Abstract

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