Abstract 12513: Poorer Cognitive Function is associated With Objectively Monitored Medication Adherence in Patients With Heart Failure
Introduction: Cognitive impairment is prevalent in heart failure (HF); however, its role in HF treatment adherence is unclear. Given the complex polypharmacy in HF treatment, cognitive deficits may be especially important in predicting medication management. Thus, the objective of the current study was to examine the impact of cognitive function on medication adherence among patients with HF using gold standard, objective assessments: neuropsychological testing and electronic pill-box monitoring.
Hypothesis: Diminishing cognitive functioning will be associated with poorer medication adherence.
Methods: Participants were 372 patients with HF (59.7% male, 68.7±9.7 years) who completed a full neuropsychological battery. Medication adherence was objectively measured for 21 days using the Medisgnals pillbox. Regression analyses tested whether baseline attention, executive function, or memory predicted 21-day medication adherence.
Results: In unadjusted analyses, lower scores on all three cognitive domains predicted poorer medication adherence (β = .52-85, p = .001-.009). After adjusting for demographic, clinical, and psychosocial variables, only memory continue to predict medication adherence (β = 0.51, p = .008), whereas executive function trended toward significance (β = 0.24 p = .075) and attention was no longer a predictor (β = 0.34, p = .131).
Conclusions: Poorer cognitive function, especially in regards to memory, predicted reduced medication adherence among patients with HF. This effect remained after adjustment for factors known to predict adherence, such as depression, social support, and disease severity level. Our findings emphasize that cognitive deficits are not only prevalent in HF but that they also predict clinical outcomes (i.e., adherence to medication).
Author Disclosures: M.A. Dolansky: None. M.A. Hawkins: None. J.T. Schaefer: None. A. Sattar: None. J. Gunstad: None. J.D. Redle: None. R. Josephson: None. S.M. Moore: None. J.W. Hughes: None.
- © 2015 by American Heart Association, Inc.