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Barriers to medication adherence and links to cardiovascular disease risk factor control: the Framingham Heart Study

Rachel Hennein1,2, Shih-Jen Hwang1,2, Rhoda Au3,4,5

  • 1Framingham Heart Study, Framingham, Massachusetts, USA.

Internal Medicine Journal
|December 2, 2017
PubMed

Insights

Depression in older adults hinders medication adherence, worsening cardiovascular disease risk factors like high blood pressure and cholesterol. Addressing mental health is key for better treatment outcomes.

Area of Science:

  • Gerontology
  • Cardiovascular Medicine
  • Psychiatry

Background:

  • Impaired cognition in elderly individuals can negatively impact medication adherence.
  • This non-adherence poses a significant risk to the effective management of cardiovascular disease (CVD).

Purpose of the Study:

  • To investigate risk factors for medication non-adherence in older adults.
  • To examine the association between medication adherence and CVD risk factors in an aging population with hypertension, dyslipidemia, and diabetes.

Main Methods:

  • Utilized the Morisky Medication Adherence Scale on 1559 participants (median age 70).
  • Assessed CVD risk factors and measured cognitive function (MMSE) and depressive symptoms (CES-D).
  • Defined low adherence as a score of 2 or higher on the adherence scale.

Main Results:

  • 12% of participants exhibited low medication adherence.
  • Increased depressive symptoms (CES-D score) significantly raised the risk of low adherence (45% increase per 5-unit rise).
  • Low adherence correlated with higher diastolic blood pressure and LDL cholesterol levels in relevant subgroups.

Conclusions:

  • Depressive symptoms represent a significant barrier to medication adherence in older adults.
  • Poor adherence exacerbates key cardiovascular disease risk factors, underscoring the need for integrated care approaches.
Abstract

Keywords:
cardiovascular diseasescholesteroldiabetes mellitus, Type 2hypertensionmedication adherence

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