Abstract 2509: Spouses Enhance Medication Adherence in Patients with Heart Failure
Background: Nonadherence to prescribed medications is a primary cause of rehospitalization in patients with heart failure (HF). Although positive spousal support is related to long-term outcomes in HF patients, direct effects of having a spouse on adherence is unknown. The purpose of this study was to examine the impact of patients’ marital status on adherence to medication.
Methods: Adherence to medication was assessed in 92 patients (male 61%; ejection fraction 32 ± 14%; mean age of 60 years) using the electronic Medication Event Monitoring System (MEMS). Medication adherence rate was calculated as the percent of the prescribed number of doses taken over an average of 94 days. To rule out the potential confound of depression level, we assessed patients’ depression level using the Beck Depression Inventory-II.
Results: MEMS data revealed that, on average, patients took 87% of prescribed doses; only 67% of medication doses were taken on time. There was no difference in age, education, number of prescribed medication, or depression level between patients with (61%) and without (39%) a spouse. Compared to patients without a spouse, patients with a spouse took more prescribed doses (90% vs. 80%, p < .05) and took more doses on schedule (70% vs. 49%, p < .01). Patients with a spouse expressed greater agreement with the importance of taking medication on time. They were also more knowledgeable about names and doses of prescribed medications. In a test of a multiple logistic regression model consisting of marital status, depression, and NYHA functional class, patients with a spouse were 3.1 times more likely to be adherent (took > 85% of medication doses as prescribed) to medication taking than patients without a spouse (95% CI = 1.06 − 9.0). The strength of this relationship was equal to that between depression and adherence (odds ratio = 3.2; 95% CI = 1.02 − 9.8). NYHA class was not a significant predictor of medication adherence.
Conclusion: Married patients had substantially better adherence to medication than patients without a spouse regardless of depression level and NYHA class. Thus, interventions aimed at improving medication adherence of married patients should target both the patient and spouse. Patients without a spouse require alternative support interventions.