Abstract 10097: Medication Adherence of the Elderly with Congestive Heart After a Hospital Discharge.
Objective: The objective of this study was to explore the little known diagnosis specific (cognitive, depression, fatigue) and personal factors (social support) that are associated with medication adherence of the elderly with Congestive Heart failure (CHF) in the first 24 hours after hospital discharge. Without this vital information about a very critical transitional period for medication compliance, nurses who provide discharge medication instructions do not know when further assessment and action planning are warranted.
Methods: The multi-method, nonexperimental, comparative study was guided by Leventhal's Self Regulatory Model (1993). Fifty-eight CHF patients discharged to their homes participated in the study. Ages ranged from 60 to 101 years (mean 71.60, SD 9.036) with 31 males and 27 females. In the hospital prior to discharge clock-drawing cognitive test, Short Form Center for Epidemiologic Studies Depression Scale, Daily Fatigue Impact Scale, medication social support section of Medication Assessment Tool, and Medication Regimen Complexity Index (MRCI) were assessed. Forty-eight hours after discharge participants were telephoned and asked to report medications taken and respond to the medication social support questionnaire.
Findings: On the day of discharge 72% (n=42) reported not taking one or more of their medications with 67% (n=39) the day after. Fifty-two percent (n=30) reported fatigue and 57% (n=33) reported low levels for depression. Fifty-five percent (n=32) did not pass the clock drawing test. Intentional nonadherence likelihood was found in 100% (13/13) who did not pass the clock drawing test and who had no social support in the giving of medications 48 hours after discharge. Unintentional nonadherence likelihood was found for 78% (28/36) on the day of discharge and 79% (23/29) the day after for ≥ 10 medications prescribed. Likelihood for nonadherence was 81% (34/42) on the day of discharge and 79% (31/39) the day after for MRCI ≥20.
Conclusion: The results indicate the potential for elderly patients with CHF to have difficulty with medication adherence after discharge due to lack of social support in the giving of medications, failed clock drawing test, ≥ 10 medications prescribed, and medication regime complexity.
- © 2010 by American Heart Association, Inc.