title: Effect of a medication-taking behavior feedback theory-based intervention on outcomes in patients with heart failure.
abstract: BACKGROUND
  Medication nonadherence contributes to hospitalization and mortality, yet there have been few interventions tested that improve adherence and reduce hospitalization and mortality in heart failure (HF). Our objective was to determine whether an education intervention improved medication adherence and cardiac event-free survival.
  
  
  RESULTS
  A randomized controlled trial was conducted on 82 HF patients. The intervention was based on the theory of planned behavior (TPB) and included feedback of medication-taking behavior using the Medication Event Monitoring System (MEMS). Patients were assigned to one of three groups: 1) theory-based education plus MEMS feedback; 2) theory-based education only; or 3) usual care (control). Cardiac events were collected for 9 months. Patients in both intervention groups were more adherent over follow-up compared with the control group. In Cox regression, patients in either intervention group had a longer event-free survival compared with those in the control group before and after controlling age, marital status, financial status, ejection fraction, New York Heart Association functional class, angiotensin-converting enzyme inhibitor use, and presence or absence of a significant other during the intervention (P < .05).
  
  
  CONCLUSIONS
  Use of an intervention based on the TPB improves medication adherence and outcomes in patients with HF and therefore offers promise as a clinically applicable intervention to help patients with HF to adhere to their prescribed regimen.
authors.affiliation: School of Nursing, University of North Carolina, Chapel Hill, North Carolina 27599-7460, USA. jiarongw@email.unc.edu
authors.forename: Jia-Rong
authors.initials: JR
authors.lastname: Wu
authors.forename: Donna J
authors.initials: DJ
authors.lastname: Corley
authors.forename: Terry A
authors.initials: TA
authors.lastname: Lennie
authors.forename: Debra K
authors.initials: DK
authors.lastname: Moser
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage; D001521:Behavior Therapy; D005260:Female; D006333:Heart Failure / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007629:Kentucky; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D016016:Proportional Hazards Models; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors