Patient-Reported Outcomes and Medication Adherence in Patients with Heart Failure

Anne Ankerstjerne Rasmussen*, Henrik Wiggers, Martin Jensen, Selina Kikkenborg Berg, Trine Bernholdt Rasmussen, Britt Borregaard, Lars Thrysoee, Charlotte Brun Thorup, Rikke Elmose Mols, Signe Holm Larsen, Søren Paaske Johnsen

*Kontaktforfatter

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

19 Citationer (Scopus)

Abstract

AIM: Patient-reported outcome measures (PROMs) may predict poor clinical outcome in patients with heart failure (HF). It remains unclear whether PROMs are associated with subsequent adherence to HF medication. We aimed to determine whether health-related quality of life, anxiety and depression were associated with long-term medication adherence in these patients.

METHODS AND RESULTS: A national cohort study of Danish patients with HF with three-year follow-up (n = 1,464). PROMs included the EuroQol five-dimensional, five-level questionnaire (EQ-5D-5L), the HeartQoL and the Hospital Anxiety and Depression Scale (HADS). Patient-reported outcomes (PRO) data were linked to demographic and clinical data at baseline, and data on all redeemed prescriptions for angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers/angiotensin receptor neprilysin inhibitors (ACEI/ARB/ARNI), β-blockers and mineralocorticoid receptor antagonists (MRAs) during follow-up. Medication non-adherence was defined as < 80% of proportion of days covered (PDC). In adjusted regression analyses, lower health-related quality of life (EQ-5D and HeartQoL) and symptoms of depression (HADS-D) at discharge were associated with non-adherence. After three years of follow-up, lower health-related quality of life (EQ-5D) was associated with non-adherence for ACEI/ARB/ARNI (adjusted OR 2.78, 95% CI:1.19-6.49), β-blockers (adjusted OR 2.35, 95% CI:1.04-5.29), whereas HADS-D was associated with non-adherence for ACEI/ARB/ARNI (adjusted OR 1.07, 95% CI:1.03-1.11) and β-blockers (adjusted OR 1.06, 95% CI:1.02-1.10).

CONCLUSION: Lower health-related quality of life and symptoms of depression were associated with non-adherence across HF medications at one- and three years of follow-up. Person-centred care using PROMs may carry a potential for identifying patients at increased risk of future medication non-adherence.

OriginalsprogEngelsk
TidsskriftEuropean Heart Journal - Cardiovascular Pharmacotherapy
Vol/bind7
Udgave nummer4
Sider (fra-til)287–295
Antal sider9
ISSN2055-6837
DOI
StatusUdgivet - jul. 2021

Bibliografisk note

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.

Fingeraftryk

Dyk ned i forskningsemnerne om 'Patient-Reported Outcomes and Medication Adherence in Patients with Heart Failure'. Sammen danner de et unikt fingeraftryk.

Citationsformater