title: Age-related medication adherence in patients with chronic heart failure: A systematic literature review.
abstract: BACKGROUND
  Chronic heart failure (CHF) is prevalent among the elderly and is characterized by high mortality and hospitalization rates. Non-adherence to medications is frequent and related to poor clinical outcomes. It is often assumed that older age is related to poorer medication adherence compared with younger age. We analyzed the existing evidence of age as a determinant of medication adherence in patients with CHF.
  
  
  METHODS
  A systematic search of the bibliographic database MEDLINE and all Cochrane databases was performed. Studies were included if they examined medication adherence in adult patients with CHF, evaluated factors contributing to medication adherence, and analyzed the relationship between age and medication adherence. Articles classified as studies with poor quality were excluded.
  
  
  RESULTS
  A total of 1565 titles were found, and ultimately, 17 studies, which provide data for a total of 162,727 patients, were analyzed. Seven studies showed a statistically significant relationship between age and medication adherence: six articles demonstrated that increased age is correlated with higher medication adherence, and one study showed that patients in the age range of 57 to 64 years are affected by non-adherence to angiotensin-converting enzyme inhibitors. Ten studies found no significant relationship.
  
  
  CONCLUSIONS
  The results suggest that older age alone is not related to poorer medication adherence compared with younger patients with CHF. More attention should be paid to younger newly-diagnosed patients with CHF. Future studies are required to explore medication adherence in CHF in different, standardized, and specific age groups and should be sufficiently powered to assess clinical endpoints.
authors: ABDA - Federal Union of German Associations of Pharmacists, Department of Medicine, Berlin, Germany. Electronic address: k.krueger@abda.de.
authors: Katrin
authors: K
authors: Krueger
authors: ABDA - Federal Union of German Associations of Pharmacists, Department of Medicine, Berlin, Germany.
authors: Lea
authors: L
authors: Botermann
authors: German Agency for Quality in Medicine, Berlin, Germany.
authors: Susanne G
authors: SG
authors: Schorr
authors: ABDA - Federal Union of German Associations of Pharmacists, Department of Medicine, Berlin, Germany.
authors: Nina
authors: N
authors: Griese-Mammen
authors: Klinik für Innere Medizin III (Kardiologie, Angiologie und Internistische Intensivmedizin), Universitätsklinikum des Saarlandes, Homburg, Germany.
authors: Ulrich
authors: U
authors: Laufs
authors: ABDA - Federal Union of German Associations of Pharmacists, Department of Medicine, Berlin, Germany; Department of Pharmacology, Goethe-University Frankfurt, Frankfurt at Main, Germany.
authors: Martin
authors: M
authors: Schulz
mesh_terms: D000367:Age Factors; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D002908:Chronic Disease; D006333:Heart Failure / Q000175:diagnosis* / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D055118:Medication Adherence / Q000523:psychology
chemical_list: D002317:Cardiovascular Agents
keywords: Age; Chronic heart failure; Elderly; Medication adherence; Systematic literature review