A qualitative secondary data analysis of intentional and unintentional medication nonadherence in adults with chronic heart failure.
OBJECTIVE
To explore factors contributing to intentional and unintentional medication nonadherence in adults with chronic heart failure (HF).


BACKGROUND
Medication nonadherence is prevalent in HF but the factors contributing to it are not well understood.


METHODS
This secondary data analysis of qualitative data explored narrative accounts about medication adherence from four previous studies (N = 112). The Necessity-Concerns-Framework derived from the Common Sense Model (CSM) of Self-Regulation guided the interpretation of themes.


RESULTS
In this diverse sample (39% Black, 6% Hispanic, 63% male; mean age 59 ± 15 years), 90% reported at least intermittent nonadherence. For many (60%), missing medication was unintentional but 27% reported intentional nonadherence. Four interconnected patterns of behavior emerged: 1) rarely nonadherent, 2) frequently nonadherent, 3) intentionally nonadherent, and 4) reformed nonadherent. Misperceptions about HF, beliefs, concerns, and contextual factors contributed to both intentional and unintentional nonadherence.


CONCLUSIONS
Medication nonadherence is prevalent in HF and influenced by modifiable factors.
University of Pennsylvania School of Nursing, United States. Electronic address: briegel@nursing.upenn.edu.
Barbara
B
Riegel
New York University Rory Meyers College of Nursing, United States.
Victoria Vaughan
VV
Dickson
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003627:Data Interpretation, Statistical; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D015995:Prevalence; D012959:Socioeconomic Factors; D016903:Drug Monitoring
Common sense model; Heart failure; Medication adherence; Qualitative symptoms; Self-care