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Self-reported adherence with medication and cardiovascular disease outcomes in the Second Australian National Blood Pressure Study (ANBP2)
journal contribution
posted on 2023-05-16, 18:52 authored by Mark NelsonMark Nelson, Reid, C, Ryan, P, Willson, K, Yelland, LObjective: To investigate whether responses to a previously validated four-item medication adherence questionnaire were associated with adverse cardiovascular events. Design: Survey conducted among a cohort of participants in the Second Australian National Blood Pressure Study. Setting: Australian general practice. Participants: 4039 older people with hypertension. Main outcome measures: All major cardiovascular events or death; first specific cardiovascular event. Results: Subjects who adhered to their medication regimen (compared with non-adherent subjects) were significantly less likely to experience a first cardiovascular event or a first non-fatal cardiovascular event (hazard ratio [HR] for both, 0.81; 95% CI, 0.67-0.98; P = 0.03); a fatal other cardiovascular event (HR, 0.68; 95% CI, 0.48-0.99; P = 0.04); or a first occurrence of heart failure (HR, 0.58; 95% CI, 0.37-0.90; P = 0.02). Those who answered yes to "Did you ever forget to take your medication?" were significantly more likely to experience a cardiovascular event or death (HR, 1.28; 95% CI, 1.04-1.57; P = 0.02); a first cardiovascular event or death (HR, 1.31; 95% CI, 1.07-1.60; P = 0.01); a first cardiovascular event (HR, 1.34; 95% CI, 1.09-1.65; P = 0.01); or a first non-fatal cardiovascular event (HR, 1.35; 95% CI, 1.09-1.66; P = 0.01). Those who answered yes to "Sometimes, if you felt worse when you took your medicine, did you stop taking it?" were significantly more likely to experience a first occurrence of heart failure (HR, 2.06; 95% CI, 1.16-3.64; P = 0.01). Conclusions: Subjects who adhered to their medication regimen were less likely to experience major cardiovascular events or death. The question relating to forgetting to take medication identified non-adherent subjects likely to experience a cardiovascular event or death. Clinicians could use this question to identify patients with hypertension who are likely to benefit from medication adherence strategies.
History
Publication title
Medical Journal of AustraliaVolume
185Issue
9Pagination
487-489ISSN
0025-729XDepartment/School
Menzies Institute for Medical ResearchPublisher
Australasian Med Publ Co LtdPlace of publication
Pyrmont, AustraliaRepository Status
- Restricted