title: Type D personality predicts poor medication adherence in patients with heart failure in the USA.
abstract: BACKGROUND
  Type D (distressed) personality and medication nonadherence have been associated with poor health outcomes. Type D personality is associated with poor medication adherence in patients with coronary artery disease. However, the relationship between type D personality and medication adherence in patients with heart failure (HF) remains unknown.
  
  
  OBJECTIVE
  Therefore, the goal of this study was to examine the association between type D personality and medication adherence in patients with HF.
  
  
  METHODS
  This was a sub-analysis of baseline data from a randomized controlled trial with 84 patients with HF in the USA. Demographic, clinical, and psychological data were collected at baseline by interview, questionnaires, and medical record review. Type D personality was assessed using the Type D Personality Scale (DS14). Medication adherence was measured using both objective (Medication Event Monitoring System, MEMS) and self-reported (Morisky Medication Adherence Scale, MMAS-4) measures. Patients started medication adherence monitoring with the MEMS bottle at baseline and is used continuously for a month. Multiple regressions were used to explore the relationships between type D personality and medication adherence while adjusting for demographic, clinical, and psychological factors.
  
  
  RESULTS
  Patients with type D personality were more likely to have poor medication adherence. Type D personality was associated with medication adherence before and after adjusting for covariates when it was analyzed as a categorical variable. However, type D personality was not associated with medication adherence when analyzed as a dimensional construct. Negative affectivity, a component of type D personality, was associated with medication adherence.
  
  
  CONCLUSIONS
  As a dimensional construct, type D personality may not reflect the components of the personality associated with poor outcomes. Negative affectivity was associated with medication adherence in patients with HF. Interventions aiming to improving/enhancing medication adherence need to take into account patients with the negative affectivity component of type D personality who are at higher risk for poor medication adherence, which may lead to adverse health outcomes.
authors.affiliation: School of Nursing, University of North Carolina at Chapel Hill, 435 Carrington Hall, CB# 7460, Chapel Hill, NC, 27599-7460, USA, jiarongw@email.unc.edu.
authors.forename: Jia-Rong
authors.initials: JR
authors.lastname: Wu
authors.forename: Debra K
authors.initials: DK
authors.lastname: Moser
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D008962:Models, Theoretical; D015999:Multivariate Analysis; D010551:Personality; D010555:Personality Inventory; D012044:Regression Analysis; D057566:Self Report; D012944:Social Support; D011795:Surveys and Questionnaires; D064415:Type D Personality; D016903:Drug Monitoring