Predictors of refill non-adherence in patients with heart failure.
OBJECTIVE
To identify the health beliefs and patient characteristics associated with medication non-adherence in patients attending a heart failure outpatient clinic.


METHODS
A survey was administered to 350 consenting clinic patients. Questions focused on relevant demographic and clinical characteristics, the Health Belief Model, the Beliefs About Medicines Questionnaire and the Multidimensional Health Locus of Control. Multivariate logistic regression was used to identify independent predictors of refill non-adherence (<90%).


RESULTS
Refill non-adherence was found in 77 (22%) participants. Being a smoker [odds ratio (OR) 2.4, 95% confidence interval (CI) 1.0, 5.8, P = 0.045], two or fewer medication administration times (OR 2.4, 95% CI 1.2, 4.6, P = 0.01), and positive response to 'Have you changed your daily routine to accommodate your heart failure medication schedule' (OR 2.4, 95% CI 1.2, 4.5, P = 0.01) were the independent predictors of refill non-adherence.


CONCLUSIONS
Perceptions regarding barriers to medication taking and fewer administration times could result in medication non-adherence in congestive heart failure patients. Medication regimens should be designed after accounting for patients' existing routines.
George
Johnson
J
School of Pharmacy, The Robert Gordon University, Aberdeen, UK. j.george@rgu.ac.uk
Shalansky
Stephen J
SJ
D001294:Attitude to Health; D001955:British Columbia; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000523:psychology; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D016312:Treatment Refusal / Q000523:psychology* / Q000706:statistics & numerical data