title: Testing a novel pictorial medication sheet to improve adherence in veterans with heart failure and cognitive impairment.
abstract: OBJECTIVE
  (a) To evaluate efficacy of a pictorial medication sheet to improve adherence in veterans with heart failure (HF) and cognitive impairment (CI); (b) to describe acceptance of the intervention.
  
  
  BACKGROUND
  CI is prevalent in HF and is associated with worsened medication adherence. The Veteran's Administration has developed a medication image library; however, use of images to improve adherence has not been tested.
  
  
  METHODS
  Thirty-six veterans with HF and CI were enrolled and provided pictorial medication sheets and an optional alarmed pillbox. Adherence pre-and post-intervention was determined by 30-day pill counts. Acceptance was assessed from interviews.
  
  
  RESULTS
  Twenty-seven veterans (75%) completed the study. Overall medication adherence was poor, however there was significant improvement from pre-intervention (M = 79.74, SD = ±16.98) to post-intervention (M = 84.74, SD = ±10.00) adherence (t(26) = 2.16, p < .05, Cohen's d = .42).
  
  
  CONCLUSIONS
  This pilot study provides preliminary evidence that medication images improve adherence with complex medication regimens. The intervention was well received by patients.
authors.affiliation: Indiana Wesleyan University, Marion, IN, USA; VA Loma Linda Healthcare System, Loma Linda, CA, USA. Electronic address: Leeann.hawkins@indwes.edu.
authors.forename: Lee Ann
authors.initials: LA
authors.lastname: Hawkins
authors.affiliation: VA Loma Linda Healthcare System, Loma Linda, CA, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Firek
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D010865:Pilot Projects; D015995:Prevalence; D014728:Veterans
keywords: Cognitive impairment; Heart failure; Hospital readmission; Medication adherence; Medication reconciliation