Abstract 20518: Improved Adherence to Heart Failure Medications Correlates With Reduced Mortality
Introduction: Adherence to heart failure (HF) medication regimens is associated with improved outcomes, such as reduced mortality. However, many studies define adequate adherence as 80% despite a lack of empirical support regarding what level of adherence is needed to achieve improved outcomes. One study reported that ≥ 88% adherence was the level at which mortality was reduced. The purpose of this secondary analysis was to confirm the level of adherence at which medication adherence correlates with reduced mortality.
Methods: The parent study was a longitudinal descriptive study to determine the relationship between cognitive impairment and self-management. In the current sample (N = 303), adherence of four medications was monitored over a three week period with an electronic pill box (Medsignals). Medication adherence was defined as the percentage of days that the correct number of prescribed doses were taken. All-cause mortality was obtained from the National Death Index with a median follow-up of 2.87 years. Multiple Kaplan-Meier plots with log-rank tests, and Cox survival analyses were performed at one-point incremental cut-off scores.
Results: During follow-up, 51 deaths (16.8%) occurred. Average medication adherence was 73.05%. All-cause mortality was lower when adherence was > 84%. A Cox regression model confirmed this cut-off after controlling for age, gender, ejection fraction, New York Heart Association Class, comorbidity, angiotensin-converting enzyme inhibitor use, and B-blocker use (HR: 0.56, 95% CI: (.31-.99), p = .045).
Conclusion: Consistent with a prior study, the present results confirm that adherence rates higher than 80% may be necessary to reduce risk of death. Further research with specific HF medications is needed, given varied biologic effects.
Author Disclosures: A.M. Vehovec: None. E. Gathright: None. M.A. Dolansky: None. R. Josephson: None. J. Hughes: None.
- © 2016 by American Heart Association, Inc.