The association between multimorbidity and poor adherence with cardiovascular medications

Purpose Cardiac rehabilitation (CR) is a program of structured exercise and interventions for coronary risk factor reduction that reduces morbidity and mortality following a major cardiac event. Although a dose response relationship between number of CR sessions completed and health outcomes has been demonstrated, adherence with CR is not high. In this study we examined associations between number ofsessions completed within CR and patient demographics, clinical characteristics, smoking status, and socioeconomic status (SES). Methods Multiple LogisticRegression and Classification and Regression Tree (CART) modeling were used to examine associations between participant characteristics measured at CR intake and number of sessions completed in a prospectively collected CR clinical database (N=1658). Results Current smoking, lower-SES, non-surgical diagnosis, exercise-limiting comorbidities, and lower age independently predicted fewer sessions completed. The CART analysis illustrates how combinations of these characteristics (i.e., risk profiles) predict number of sessions completed. Those with the highest-risk profile for non-adherence (less than 65 years old, current smoker, lower-SES) completed on average 9 sessions while those with the lowest-risk profile (greater than 72 years old, not current smoker, higher-SES, surgical diagnosis) completed on average 27 sessions. Conclusions Younger individuals, as well as those who report smoking, economic challenges, or have a non-surgical diagnosis, may require additional support to maintain CR session attendance.

show abstract

“…41 Similar effects can be seen in other studies of medication adherence in different populations. 42,43 …”

Section: Discussionmentioning

confidence: 99%

Patient Characteristics Predictive of Cardiac Rehabilitation Adherence

Gaalema

Savage

Rengo

et al. 2017

Journal of Cardiopulmonary Rehabilitation and Prevention

View full text Add to dashboard Cite

show abstract

“…Multimorbidity, defined as the presence of two or more chronic conditions, may be associated with poorer adherence to cardiovascular medications in China (Wong et al . ). Polypharmacy, or the use of multiple prescribed medications, has been demonstrated to increase nonadherence in older patients (Chiang‐Hanisko et al .…”

Section: Methodsmentioning

confidence: 97%

Electronic messaging support service programs improve adherence to lipid‐lowering therapy among outpatients with coronary artery disease: an exploratory randomised control study

Fang

2015

Journal of Clinical Nursing

View full text Add to dashboard Cite

show abstract

“…People affected by multimorbidity often experience fragmentation of care, greater and inadequate use of health services 5 and polypharmacy, 6 which in turn may increase the risk of low adherence and adverse drug reactions. 7 , 8 All of this leads to individuals’ quality of life deterioration 9 and higher risk of mortality. 10 Besides, handling patients with multimorbidity represents a daily challenge for physicians and health systems.…”

Section: Why Was the Cohort Set Up?mentioning

confidence: 99%