Abstract 12651: Medication Adherence Mediates the Relationship Between Heart Failure Symptoms and Cardiac Event-Free Survival in Patients With Heart Failure
Background: Heart failure (HF) symptoms such as dyspnea and ankle swelling are common and may precipitate hospitalization. Poor medication adherence is presumed to be associated with symptom exacerbations and hospitalization, yet how HF symptoms, medication adherence, and hospitalization are related remain unclear.
Objective: The purpose of this study was to explore the relationships among HF symptoms, medication adherence, and cardiac event-free survival in patients with HF.
Methods: We enrolled 219 patients with HF (male 65%, age 60±12). Patients’ demographic and clinical data were collected at baseline. Medication adherence was monitored using the Medication Event Monitoring System. HF symptoms were assessed using the Self-Care of Heart Failure Index. Patients were followed for up to 3 1/2 years to collect outcome data. Cardiac events (cardiac rehospitalization and mortality) were obtained by patient/family interview and hospital database review. Linear regression and survival analyses were used for data analyses.
Results: HF patients who reported dyspnea or ankle swelling were more likely to have poor medication adherence (p = .05). Poor medication adherence was associated with worse cardiac event-free survival (p =.006). In Cox regression, patients with HF symptoms had 2 times greater risk for a cardiac event than patients without HF symptoms (p = .042). HF symptom was not a significant predictor of cardiac event-free survival after entering medication adherence in the model (p = .091), indicating mediation of the relationship between HF symptoms and outcomes by medication adherence (Figure).
Conclusion: Medication adherence mediated the relationship between HF symptoms and cardiac event-free survival in this sample. It is important to develop interventions to improve medication adherence to reduce HF symptoms and high hospitalization and mortality rates in patients with HF.
Author Disclosures: J. Wu: Research Grant; Modest; NIH/NINR grant. D.K. Moser: None.
- © 2015 by American Heart Association, Inc.