Examination of factors that impact medication adherence among heart failure patients in Southern rural counties




Washington, Rosalind

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Approximately 5.7 million people in the United States have been diagnosed with heart failure as of 2012, with an estimated annual cost of $34.4 billion (Centers for Disease Control and Prevention [CDC], 2012a). Expenditures associated with heart failure include healthcare services, medications, and lost work productivity (CDC, 2012a). Treatment for those who suffer from heart failure relies heavily upon adherence to specific medications and other treatment regimens. The appropriate use of medication is essential to self-management of most chronic diseases such as heart failure; however, it is estimated that over 50% of prescribed medication is not taken as directed by patients with cardiovascular disease, including heart failure (Horne & Weinman, 1999). The purpose of this study was to examine the relationships among perceived severity, beliefs about medication, necessity-concern of medication and medication adherence among Medicare eligible patients with HF receiving treatment from the University of Arkansas for Medical Sciences-Area Health Education Centers (UAMS-AHEC). The majority of the 81 heart failure patients sampled from the two clinic locations in the Texarkana, Arkansas area indicated prescribed medications were essential for maintaining their health. Participants with negative beliefs about prescribed medications were more likely to have lower medication adherence and those with positive beliefs about medication revealed higher medication adherence. Participants with higher perceived severity of heart failure reported lower medication adherence, while those with lower perceived severity of heart failure reported higher medication adherence. This research study provided a one-time event snapshot of patients' self-reported behaviors relative to medication usage and possible relationships among other modifying factors that may facilitate or mediate adherence. In clinical practice, the discovery of patients' beliefs about medication during the early stage of diagnosis could aid in establishing better communication and education to promote sustainable medication adherence.



Health sciences, Beliefs, HBM, Health belief model, Heart failure, Medication Adherence, Rural health