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Results of the Chronic Heart Failure Intervention to Improve MEdication Adherence study: A randomized intervention in high-risk patients.

Publication ,  Journal Article
Granger, BB; Ekman, I; Hernandez, AF; Sawyer, T; Bowers, MT; DeWald, TA; Zhao, Y; Levy, J; Bosworth, HB
Published in: Am Heart J
April 2015

BACKGROUND: Poor adherence to evidence-based medications in heart failure (HF) is a major cause of avoidable hospitalizations, disability, and death. To test the feasibility of improving medication adherence, we performed a randomized proof-of-concept study of a self-management intervention in high-risk patients with HF. METHODS: Patients with HF who screened positively for poor adherence (<6 Morisky Medication Adherence Scale 8-item) were randomized to either the intervention or attention control group. In the intervention group (n = 44), a nurse conducted self-management training before discharge that focused on identification of medication goals, facilitation of medication-symptom associations, and use of a symptom response plan. The attention control group (n = 42) received usual care; both groups received follow-up calls at 1 week. However, the content of follow-up calls for the attention control group was unrelated to HF medications or symptoms. General linear mixed models were used to evaluate the magnitude of change in adherence and symptom-related events at 3-, 6-, and 12-month follow-up clinic visits. Efficacy was measured as improved medication adherence using nurse-assessed pill counts at each time point. RESULTS: Pooled over all time points, patients in the intervention group were more likely to be adherent to medications compared with patients in the attention control group (odds ratio 3.92, t = 3.51, P = .0007). CONCLUSIONS: A nurse-delivered, self-care intervention improved medication adherence in patients with advanced HF. Further work is needed to examine whether this intervention can be sustained to improve clinical outcomes.

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Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

April 2015

Volume

169

Issue

4

Start / End Page

539 / 548

Location

United States

Related Subject Headings

  • United States
  • Survival Rate
  • Self Care
  • Risk Factors
  • Prospective Studies
  • Prognosis
  • Middle Aged
  • Medication Adherence
  • Male
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
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Granger, B. B., Ekman, I., Hernandez, A. F., Sawyer, T., Bowers, M. T., DeWald, T. A., … Bosworth, H. B. (2015). Results of the Chronic Heart Failure Intervention to Improve MEdication Adherence study: A randomized intervention in high-risk patients. Am Heart J, 169(4), 539–548. https://doi.org/10.1016/j.ahj.2015.01.006
Granger, Bradi B., Inger Ekman, Adrian F. Hernandez, Tenita Sawyer, Margaret T. Bowers, Tracy A. DeWald, Yanfang Zhao, Janet Levy, and Hayden B. Bosworth. “Results of the Chronic Heart Failure Intervention to Improve MEdication Adherence study: A randomized intervention in high-risk patients.Am Heart J 169, no. 4 (April 2015): 539–48. https://doi.org/10.1016/j.ahj.2015.01.006.
Granger BB, Ekman I, Hernandez AF, Sawyer T, Bowers MT, DeWald TA, et al. Results of the Chronic Heart Failure Intervention to Improve MEdication Adherence study: A randomized intervention in high-risk patients. Am Heart J. 2015 Apr;169(4):539–48.
Granger, Bradi B., et al. “Results of the Chronic Heart Failure Intervention to Improve MEdication Adherence study: A randomized intervention in high-risk patients.Am Heart J, vol. 169, no. 4, Apr. 2015, pp. 539–48. Pubmed, doi:10.1016/j.ahj.2015.01.006.
Granger BB, Ekman I, Hernandez AF, Sawyer T, Bowers MT, DeWald TA, Zhao Y, Levy J, Bosworth HB. Results of the Chronic Heart Failure Intervention to Improve MEdication Adherence study: A randomized intervention in high-risk patients. Am Heart J. 2015 Apr;169(4):539–548.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

April 2015

Volume

169

Issue

4

Start / End Page

539 / 548

Location

United States

Related Subject Headings

  • United States
  • Survival Rate
  • Self Care
  • Risk Factors
  • Prospective Studies
  • Prognosis
  • Middle Aged
  • Medication Adherence
  • Male
  • Humans