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Changes in beliefs about medications during long-term care for ischemic heart disease.

Publication ,  Journal Article
Allen LaPointe, NM; Ou, F-S; Calvert, SB; Melloni, C; Stafford, JA; Harding, T; Alexander, KP; Peterson, ED
Published in: Am Heart J
April 2010

BACKGROUND: Beliefs such as self-reported low necessity for medications and high concerns about medications are associated with nonadherence. Changes in these beliefs during long-term care have not previously been studied and were evaluated for purposes of this analysis. METHODS: From January 2006 through September 2007, patients at 41 hospitals who met entry criteria for the CRUSADE Quality Improvement Initiative were consented for participation in a longitudinal follow-up survey study called MAINTAIN. The patients completed The Beliefs about Medicines Questionnaire at 3 and 12 months postdischarge to assess necessity and concerns related to heart medications. Internal reliability and construct validity of the survey were evaluated at both time points. Changes in necessity and concern scores from 3 to 12 months were determined, and factors associated with negative changes were explored. RESULTS: A total of 812 patients completed both surveys. Internal reliability and construct validity were good. From 3 to 12 months, only 9.2% of patients shifted from a high to low necessity score; however, 20.7% of patients shifted from a low to high concern score. Factors found to be statistically significantly and independently associated with increased concern were the perception that the provider did not listen carefully to the patient (odds ratio [OR] 2.63, 95% CI 1.49-4.76), depression at 12 months (OR 2.95, 95% CI 1.57-5.55), hospital discharge with > or =7 medications (OR 1.71, 95% CI 1.07-2.74), and not receiving a medication list/instructions at hospital discharge (OR 1.69, 95% CI 1.05, 2.78). Factors associated with decreased necessity included not having a cardiologist (OR 2.26, 95% CI 1.34-3.83) and nonpersistence at 12 months with lipid-lowering medication (OR 1.85, 95% CI 1.01-3.45). CONCLUSIONS: One third of the patients reported a negative change in their beliefs about heart medications. Although some changes were observed in perceived necessity, negative changes in concerns occurred in 1 of every 5 patients. Interventions that address these concerns may be useful in improving adherence and clinical outcomes.

Duke Scholars

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

April 2010

Volume

159

Issue

4

Start / End Page

561 / 569

Location

United States

Related Subject Headings

  • Time Factors
  • Patient Compliance
  • Myocardial Ischemia
  • Middle Aged
  • Male
  • Humans
  • Female
  • Cardiovascular System & Hematology
  • Attitude to Health
  • Aged
 

Citation

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Chicago
ICMJE
MLA
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Allen LaPointe, N. M., Ou, F.-S., Calvert, S. B., Melloni, C., Stafford, J. A., Harding, T., … Peterson, E. D. (2010). Changes in beliefs about medications during long-term care for ischemic heart disease. Am Heart J, 159(4), 561–569. https://doi.org/10.1016/j.ahj.2009.12.025
Allen LaPointe, Nancy M., Fang-Shu Ou, Sara B. Calvert, Chiara Melloni, Judith A. Stafford, Tina Harding, Karen P. Alexander, and Eric D. Peterson. “Changes in beliefs about medications during long-term care for ischemic heart disease.Am Heart J 159, no. 4 (April 2010): 561–69. https://doi.org/10.1016/j.ahj.2009.12.025.
Allen LaPointe NM, Ou F-S, Calvert SB, Melloni C, Stafford JA, Harding T, et al. Changes in beliefs about medications during long-term care for ischemic heart disease. Am Heart J. 2010 Apr;159(4):561–9.
Allen LaPointe, Nancy M., et al. “Changes in beliefs about medications during long-term care for ischemic heart disease.Am Heart J, vol. 159, no. 4, Apr. 2010, pp. 561–69. Pubmed, doi:10.1016/j.ahj.2009.12.025.
Allen LaPointe NM, Ou F-S, Calvert SB, Melloni C, Stafford JA, Harding T, Alexander KP, Peterson ED. Changes in beliefs about medications during long-term care for ischemic heart disease. Am Heart J. 2010 Apr;159(4):561–569.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

April 2010

Volume

159

Issue

4

Start / End Page

561 / 569

Location

United States

Related Subject Headings

  • Time Factors
  • Patient Compliance
  • Myocardial Ischemia
  • Middle Aged
  • Male
  • Humans
  • Female
  • Cardiovascular System & Hematology
  • Attitude to Health
  • Aged