Caregiver status affects medication adherence among older home care clients with heart failure.
OBJECTIVE
For older individuals living in the community with chronic diseases such as heart failure (HF), caregivers may play an important role in medication adherence. This role may be increasingly important as cognition declines. This study aimed to 1) examine the role of caregivers in medication adherence in a complex population of older home care clients with mild cognitive impairment (MCI) and 2) examine the effect of caregiver stress on medication non-adherence.


METHODS
The interRAI Resident Assessment Instrument - Home Care (RAIHC) instrument collects comprehensive information about all individuals receiving long-term home care services in the Canadian province of Ontario. This analysis of secondary data utilized this database to examine the relationship between caregiver residence and stress on medication adherence among a subset of clients with MCI who were over age 75.


RESULTS
The prevalence of HF among the sample was 15.5%, while MCI was present in 42.3% of the sample. Among individuals with MCI, having a caregiver at the same residence reduced medication non-adherence. Additionally, caregiver stress was significantly associated with higher rates of non-adherence.


CONCLUSIONS
MCI can impair medication adherence. The presence of a caregiver at home significantly improves medication adherence in patients with HF and MCI. Supporting caregivers is an important strategy in allowing clinically complex older adults to remain safely at home.
School of Public Health & Health Systems, University of Waterloo, 200 University Ave. West, Waterloo, Ontario, N2L 3G1, Canada. adfoebel@uwaterloo.ca
Andrea D
AD
Foebel
John P
JP
Hirdes
George A
GA
Heckman
D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology; D060825:Cognitive Dysfunction / Q000150:complications / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D006699:Home Care Services; D006801:Humans; D008297:Male; D055118:Medication Adherence; D009864:Ontario / Q000453:epidemiology; D012189:Retrospective Studies; D012944:Social Support