Non-Adherence in At-Risk Heart Failure Patients: Characteristics and Outcomes

David Lee, Ishak Mansi, Sujata Bhushan, Roy Parish

Internal Medicine Resident, Department of Internal Medicine; University of Texas Southwestern Medical Center, Dallas, TX, USA. Staff Internist, VA North Texas Health System; and Professor of Medicine & Clinical Sciences, Division of Outcomes and Health Services Research, University of Texas Southwestern, Dallas, TX, USA. Staff Physician, VA North Texas Health Care System and Associate Professor, Internal Medicine, UT Southwestern Medical Center, Dallas, TX, USA. College of Pharmacy, University of Louisiana Monroe; Professor of Medicine (Adjunct), Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, USA


Objective: To examine the characteristics and clinical outcomes of non-adherent heart failure patients in an at-risk population.

Methods: A retrospective cohort study including all patients admitted with heart failure during the period from June 2003 to September 2004, and followed until 2008 at a hospital serving an at-risk population. Patients were divided into adherents and non-adherents based on medical chart review. Primary outcomes were in-hospital mortality and time to readmission for heart failure.

Results: Of 357 patients included in the study, 79 patients (22.1%) were in the non-adherent group. Non-adherent patients were more likely to be younger, men, African-American, and users of illicit drugs, and less likely to have diabetes. Non-adherence was associated with shorter time to readmission (HR, 0.45; 95% CI 0.25-0.52).

Conclusion: Social and demo- graphic factors influence adherence, and may need to be considered in interventions that target improving adherence. Non-adherence was associated with decreased time to readmission. Journal of Nature and Science, 1(5):e95, 2015

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