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Predictors of β-blocker adherence in cardiac inherited disease
Claire E O'Donovan1, Kathryn E Waddell-Smith2,3, Jonathan R Skinner2,3
1Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand.
Insights
Patients with inherited heart conditions often struggle with beta-blocker adherence. Younger age, channelopathies, and negative beliefs about medication are linked to non-adherence, highlighting needs for better patient support.
Area of Science:
- Cardiology
- Pharmacology
- Psychology
Background:
- Suboptimal adherence to beta-blocker therapy is a significant risk factor for sudden cardiac death in patients with cardiac inherited diseases (CID).
- Understanding factors influencing adherence is crucial for improving long-term management and patient outcomes.
Purpose of the Study:
- To identify clinical and psychosocial variables associated with non-adherence to long-term beta-blocker therapy in the CID population.
- To inform the development of targeted interventions to enhance medication adherence.
Main Methods:
- A registry-based study involving 130 individuals with CID on beta-blocker therapy.
- Participants completed questionnaires assessing adherence, confidence, illness perceptions, and medication beliefs.
- Demographic and clinical data were obtained from the New Zealand Cardiac Inherited Disease Registry.
Main Results:
- 16% of participants reported non-adherence to beta-blocker therapy.
- Non-adherence was associated with younger age, channelopathy (vs. cardiomyopathy), lower confidence in medication, higher concerns, lower necessity beliefs, poorer understanding of CID, and lower treatment control beliefs.
- Beliefs about medication necessity and confidence in taking medication were significant predictors of adherence, explaining 37% of the variance.
Conclusions:
- Younger age, specific genetic channelopathies, negative medication beliefs, low self-efficacy, and poor illness perceptions are key factors in beta-blocker non-adherence among CID patients.
- These findings underscore the need for tailored interventions to improve medication adherence in this vulnerable population.
Objective:
The cardiac inherited disease (CID) population has suboptimal adherence to long-term β-blocker therapy, which is known to be a risk for sudden cardiac death. This study aimed to identify the clinical and psychosocial variables associated with non-adherence in this population.
Methods:
130 individuals (aged 16-81 years, median: 54) from the New Zealand Cardiac Inherited Disease Registry taking β-blockers participated: 65 (50%) long QT syndrome, 42 (32%) hypertrophic cardiomyopathy and 23 (18%) other. Participants completed one questionnaire recording self-reported adherence, anxiety, depression, confidence in taking medication, illness perceptions and medication beliefs. Demographic and clinical variables were taken from the registry.
Results:
21 participants (16%) were classed as non-adherent. Bivariate analysis showed that self-reported adherence was worse in those who were younger (p<0.001), had a channelopathy not cardiomyopathy (p<0.01), reported lower confidence in taking β-blockers (p<0.001), had high concerns (p<0.05) and low necessity beliefs about their β-blocker (p<0.001), a poorer understanding of their CID (p<0.01), and lower treatment control beliefs (p<0.01). These variables accounted for 37% of the variance in adherence in a linear regression model. Stronger beliefs around medication necessity and higher confidence in their ability to take their medication predicted β-blocker adherence.
Conclusions:
Factors associated with β-blocker non-adherence in patients with CID include young age, having a channelopathy, negative medication beliefs, low confidence in taking medication and poor illness perceptions. These findings present an opportunity to develop targeted interventions to improve adherence.
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