Association of depression and anxiety with adherence in primary care patients with heart failure—cross-sectional results of the observational RECODE-HF cohort study

2020 ◽  
Vol 37 (5) ◽  
pp. 695-702 ◽  
Author(s):  
Marion Eisele ◽  
Malte Harder ◽  
Anja Rakebrandt ◽  
Sigrid Boczor ◽  
Gabriella Marx ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Cohort Study ◽  
Psychological Distress ◽  
Medication Adherence ◽  
Failure Diagnosis ◽  
Cross Sectional ◽  
Factors Associated ◽  
Patients With Heart Failure ◽  
Heart Failure Diagnosis

Abstract Background Psychological distress has a negative impact on the prognosis and quality of life for patients with heart failure. We investigated the association between psychological distress and the patients’ adherence to medical treatment (medication adherence) and self-care advice (lifestyle adherence) in heart failure. We further examined whether there are different factors associated with low medication compared to low lifestyle adherence. Method This secondary analysis of the RECODE-HF cohort study analyzed baseline data of 3099 primary care heart failure patients aged 74 ± 10 years, 44.5 % female. Using multivariable regression, factors relating to medication and lifestyle adherence were investigated in order to estimate the extent to which these factors confound the association between psychological distress and adherence. Results Psychological distress was significantly associated with poorer medication adherence but not with lifestyle adherence after controlling for confounders. We identified different factors associated with medication compared to lifestyle adherence. A higher body mass index, a less developed social network, living alone, fewer chronic co-morbidities and unawareness of the heart failure diagnosis were only related to lower lifestyle adherence. Higher education was associated with poorer medication adherence. Male sex, younger age, lower self-efficacy and less familiar relation with the general practitioner were common factors associated with both lower medication and lifestyle adherence. Conclusion Promising factors for increasing medication adherence (reduction of psychological distress) and lifestyle adherence (explaining the patient his/her heart failure diagnosis more than once and increase in the patients’ self-efficacy), which were found in this cross-sectional study, must be further investigated in longitudinal studies.

scholarly journals Validation of heart failure diagnosis registered in primary care records in two primary care centres in Barcelona (Spain) and factors related. A cross-sectional study

2017 ◽  
Vol 23 (1) ◽  
pp. 107-113 ◽  
Author(s):  
Jose María Verdú-Rotellar ◽  
Eva Frigola-Capell ◽  
Rosa Alvarez-Pérez ◽  
Daniela da Silva ◽  
Cristina Enjuanes ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Cross Sectional Study ◽  
Failure Diagnosis ◽  
Sectional Study ◽  
Cross Sectional ◽  
Heart Failure Diagnosis

scholarly journals Route to heart failure diagnosis in English primary care: a retrospective cohort study of variation

2019 ◽  
Vol 69 (687) ◽  
pp. e697-e705 ◽  
Author(s):  
Dani Kim ◽  
Benedict Hayhoe ◽  
Paul Aylin ◽  
Azeem Majeed ◽  
Martin R Cowie ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Patient Characteristics ◽  
Deprivation Level ◽  
Factors Associated ◽  
Evidence Based Guidelines ◽  
Heart Failure Diagnosis

BackgroundDespite the existence of evidence-based guidelines supporting the identification of heart failure (HF) in primary care, the proportion of patients diagnosed in this setting remains low. Understanding variation in patients’ routes to diagnosis will better inform HF management.AimTo identify the factors associated with variation in patients’ routes to HF diagnosis in primary care.Design and settingA retrospective cohort study of 13 897 patients diagnosed with HF between 1 January 2010 and 31 March 2013 in English primary care.MethodThis study used primary care electronic health records to identify routes to HF diagnosis, defined using the National Institute for Health and Care Excellence (NICE) guidelines, and adherence to the NICE-recommended guidelines. Multilevel logistic regression was used to investigate factors associated with the recommended route to HF diagnosis, and funnel plots were used to visualise variation between practices.ResultsFew patients (7%, n = 976) followed the recommended route to HF diagnosis. Adherence to guidelines was significantly associated with younger age (P = 0.001), lower deprivation level (P = 0.007), HF diagnosis source (P<0.001), not having chronic pulmonary disease (P<0.001), receiving further consultation for symptom(s) suggestive of HF (P<0.001), and presenting with breathlessness (P<0.001). Route to diagnosis also varied significantly between GP practices (P<0.001).ConclusionThe significant association of certain patient characteristics with route to HF diagnosis and the variation between GP practices raises concerns about equitable HF management. Further studies should investigate reasons for this variation to improve the diagnosis of HF in primary care. However, these must consider the complexities of a patient group often affected by frailty and multiple comorbidities.

Abstract P347: Sex Differences in Barriers to Antihypertensive Medication Adherence: Findings from the Cohort Study of Medication Adherence among Older Adults (CoSMO)

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Elizabeth W Holt ◽  
Cara Joyce ◽  
Adriana Dornelles ◽  
Donald E Morisky ◽  
Larry S Webber ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Medication Adherence ◽  
Antihypertensive Medication ◽  
Administrative Databases ◽  
Medication Cost ◽  
Lifestyle Modifications ◽  
Cross Sectional ◽  
Men And Women ◽  
Factors Associated

Objectives: We assessed whether socio-demographic, clinical, health care system, psychosocial, and behavioral factors are differentially associated with low antihypertensive medication adherence scores among older men and women. Methods: We conducted a cross-sectional analysis using baseline data from the Cohort Study of Medication Adherence in Older Adults (CoSMO, n=2,194). Low antihypertensive medication adherence was defined as a score <6 on the 8-item Morisky Medication Adherence Scale. Risk factors for low adherence were collected using telephone surveys and administrative databases. Results: The prevalence of low medication adherence scores did not differ by sex [15.0% (193 of 1,283) in women and 13.1% (119 of 911) in men p=0.208]. In sex-specific multivariable models, having issues with medication cost and practicing fewer lifestyle modifications for blood pressure control were associated with low adherence scores among both men and women. Factors associated with low adherence scores in men but not women included reduced sexual functioning (OR = 2.03; 95% CI: 1.31, 3.16 for men and OR = 1.28; 95% CI: 0.90, 1.82 for women), and BMI ≥25 (OR = 3.23; 95% CI: 1.59, 6.59 for men and 1.23; 95% CI: 0.82, 1.85 for women). Factors associated with low adherence scores in women but not men included dissatisfaction with communication with their healthcare provider (OR = 1.75; 95% CI: 1.16, 2.65 for women and OR =1.16 95% CI: 0.57, 2.34 for men) and depressive symptoms (OR = 2.29; 95% CI: 1.55, 3.38 for women and OR = 0.93; 95% CI: 0.48, 1.80 for men). Conclusion: Factors associated with low antihypertensive medication adherence scores differed by sex. Interventions designed to improve adherence in older adults should be tailored to account for the sex of the target population.

scholarly journals Health literacy and adherence to treatment of patients with heart failure

2019 ◽  
Vol 53 ◽  
Author(s):  
Monica Isabelle Lopes Oscalices ◽  
Meiry Fernanda Pinto Okuno ◽  
Maria Carolina Barbosa Teixeira Lopes ◽  
Ruth Ester Assayag Batista ◽  
Cassia Regina Vancini Campanharo
Keyword(s):  
Heart Failure ◽  
Medication Adherence ◽  
Health Literacy ◽  
White Women ◽  
Patient Adherence ◽  
Functional Health ◽  
Cross Sectional ◽  
Adherence To Medication ◽  
Patients With Heart Failure ◽  
Medical Questionnaire

ABSTRACT Objective: To relate the level of functional health literacy with adherence and barriers to non-adherence, rehospitalization, readmission and death in patients with heart failure. Method: A cross-sectional, analytical study with patients admitted to the emergency room with a diagnosis of heart failure. Literacy was assessed by the Newest Vital Sign. Patient adherence to medication treatment and barriers to non-compliance were assessed 90 days after discharge by the Morisky-Green test and the Brief Medical Questionnaire, respectively. Results: 100 patients participated in the study. The mean age was 63.3 years (± 15.2), with a predominance of white women. Medication adherence was low in 41.1% of participants, of which 55.9% presented inadequate literacy. Re-hospitalization and death were present in patients with inadequate literacy (p<0.001). Conclusion: The low level of literacy was directly related to lower adherence and the presence of barriers to medication adherence, as well as higher rehospitalization rates and death.

scholarly journals NT-proBNP for heart failure diagnosis in Primary Care: Costs or savings? A budget impact study

2021 ◽  
Author(s):  
Cândida Fonseca ◽  
Paulo Bettencourt ◽  
Dulce Brito ◽  
Helena Febra ◽  
Álvaro Pereira ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Budget Impact ◽  
Failure Diagnosis ◽  
Impact Study ◽  
Heart Failure Diagnosis ◽  
Care Costs

scholarly journals Mediated effects of insomnia, psychological distress and medication adherence in the association of eHealth literacy and cardiac events among Iranian older patients with heart failure: a longitudinal study

2019 ◽  
Vol 19 (2) ◽  
pp. 155-164 ◽  
Author(s):  
Chung-Ying Lin ◽  
Maryam Ganji ◽  
Mark D Griffiths ◽  
Marie Ernsth Bravell ◽  
Anders Broström ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Psychological Distress ◽  
Medication Adherence ◽  
Older Patients ◽  
Longitudinal Design ◽  
Cardiac Events ◽  
Ehealth Literacy ◽  
Patients With Heart Failure

Background: Given the importance of improving health for patients with heart failure, the present study examined the temporal associations between eHealth literacy, insomnia, psychological distress, medication adherence, quality of life and cardiac events among older patients with heart failure. Methods: With a longitudinal design older patients with echocardiography verified heart failure ( N=468; 50.4% New York Heart Association class II, mean age 69.3±7.3 years; 238 men) in need of cardiac care at seven Iranian university outpatient clinics went through clinical examinations and completed the following questionnaires at baseline: eHealth literacy scale (eHEALS, assessing eHealth literacy); 5-item medication adherence report scale (MARS-5, assessing medication adherence); Minnesota living with heart failure questionnaire (MLHFQ, assessing quality of life); insomnia severity index (ISI, assessing insomnia); and hospital anxiety and depression scale (HADS, assessing psychological distress). All the patients completed the ISI and HADS again 3 months later; and the MARS-5 6 months later. Also, their cardiac events were collected 18 months later. Three mediation models were then conducted. Results: eHealth literacy had direct and indirect effects (through insomnia and psychological distress) on medication adherence and quality of life. Moreover, eHealth literacy had protecting effects on cardiac events (hazard ratio (HR) 0.53; 95% confidence interval (CI) 0.37, 0.65) through the mediators of insomnia (HR 0.19; 95% CI 0.15, 0.26), psychological distress (HR 0.08; 95% CI 0.05, 0.12) and medication adherence (HR 0.05; 95% CI 0.04, 0.08). Conclusion: As eHealth literacy was a protector for patients with heart failure, healthcare providers may plan effective programmes to improve eHealth literacy for the population. Additional benefits of improving eHealth literacy in heart failure may be decreased insomnia and psychological distress, improved quality of life, as well as decreased cardiovascular events.

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