Abstract 17923: Who Listens to Our Advice? Predictors of Adherence to Self-Care Recommendations in Rural Patients With Heart Failure
Background: The common reality of not following a recommended course of treatment is a major cause of poor health outcomes and increased healthcare costs in patients with heart failure (HF). The purpose of this study was to identify predictors of adherence to HF self-care recommendations in rural HF patients who received an intervention to promote symptom management and self -care.
Methods: Data from 349 rural HF patients (42% female, 89% Caucasian, and 56% who were older than 65 years of age) randomized to the intervention arms of the study were used. Adherence was measured using the Heart Failure Self-Care Scale questionnaire, a brief measure that asks patients to report their adherence to a variety of recommended HF symptom management behaviors (i.e., daily weight monitoring, when to call the physician, medications, diet and exercise). The following predictors were tested: age, gender, marital status, education level, depression score (measured using the PHQ-9), anxiety score (measured the Brief Symptom Inventory), and level of perceived control (measured using the Control Attitudes Scale-R). Multivariate linear regression was used to test the model.
Results: The model to predict adherence was significant (p=0.001). Of the predictors, being male, (p=0.01), having fewer symptoms of depression (p=0.05), less anxiety (p=0.03) and higher perceived control (p=0.08) were independent predictors of better adherence.
Conclusion: Adherence is a multifaceted and challenging behavior based on the assumption that the patient agrees with the self-care recommendations. These data suggest that interventions designed to promote adherence behaviors should include an assessment of gender, symptoms of depression, anxiety and perceived control for optimal outcomes.
- © 2013 by American Heart Association, Inc.