The purpose of this investigation was to determine medication adherence rates among 3 groups of elderly individuals 62 years of age or older, experiencing comorbid conditions including at least 1 cardiovascular disorder. Data, taken from a 3-week period, were combined across the groups to calculate the percentage of prescribed doses taken, percentage of days with correct number of doses, and percentage of expected doses with the correct timing of administration. Multiple linear regression also was performed on several sociodemographic variables to determine their ability to predict adherence. Risks for poor adherence and suggestions to increase adherence are presented.
To study the influence of psychosocial resources on psychological recovery after heart transplantation, 28 patients were surveyed during their hospitalization after transplant surgery and 6 months posttransplantation. Scales from the Coping With Serious Illness Battery were used to measure psychosocial resources (social support and personal control) and psychological and functional outcomes. Psychosocial resources assessed during hospitalization were associated with recovery outcomes at 6 months posttransplantation. Personal control was positively correlated with optimism, well-being, and satisfaction with life (r = .41 to .49) and negatively correlated with anger (r = -.57) and depression (r = -.52). Social support network helpfulness and attachment with others were correlated with psychological outcomes (r = .41 to .59) and functional outcome (r = .42 to .47). Efforts directed toward enhancing perceptions of personal control, social support network helpfulness, and attachment may be useful for promoting psychosocial recovery.
This study examined adherence to angiotensin-converting enzyme inhibitor therapy among 171 heart failure clinic patients. Adherence was monitored over a 3-month period with an electronic event monitor housed in a medication bottle cap, which recorded the date and time the cap was opened and closed. The average percentage of days that the prescribed number of doses (regimen adherence) was taken over the observation period was 84%. Seventy-one percent of patients showed 85%-100% adherence with their daily regimen; 19% exhibited less than 70% adherence. The overall high rates of adherence to angiotensin-converting enzyme inhibitor therapy observed among heart failure clinic patients is consistent with research that shows improved outcomes for patients managed in heart failure clinics. Electronic medication monitoring can be useful in identifying a substantial fraction of patients who are poorly adherent so that interventions to improve adherence can be targeted toward them. Additional research is needed to develop and test adherence-enhancing interventions.
The purpose of this study was to evaluate the psychosocial impact of heart transplantation on spouses and compare the adjustment of spouses and their partners. Data were collected from 51 couples prior to transplant and 12 months posttransplant. The Psychosocial Adjustment to Illness Scale (PAIS) was used to measure adjustment in seven domains. Prior to the transplant, spouses experienced profound psychosocial distress related to their partner's illness. From pretransplant to posttransplant, PAIS total score decreased (lower scores indicate better adjustment) for spouses (M = 42, SD = 16, vs. M = 26, SD = 13). Spouses showed improvement in all domains. Posttransplant, patients' and spouses' PAIS total scores (overall adjustment) were not significantly different. Spouses reported more psychological distress than patients; patients reported more problems than spouses in vocational and domestic function. Study findings highlight the importance of sensitivity in the clinical setting to the distinct psychosocial needs of spouses.
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