Medication knowledge, adherence, and associated factors in people with congestive heart failure and chronic obstructive pulmonary disease

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Journal Article
Journal of Nursing and Healthcare of Chronic Illness, 2011, 3 (1), pp. 30 - 40
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Background. Although medicines are a key component in the self-management of chronic illness, lack of adherence is a common problem. Aim. To describe medication adherence and predictors in relation to the Multidimensional Adherence Model among older adults with chronic illness. Method. During a home interview, we collected data from 118 patients with chronic illnesses (chronic obstructive pulmonary disease and heart failure), following a recent illness exacerbation, to determine self-reported medication adherence, medication knowledge and capacity for self-management of their illness. We used the Medication Adherence Model as an organising framework and performed multivariate analyses to determine the independent predictors. We conducted the study between April 2005June 2006. Results. Participants had an average age of 75·54 years (SD 8·38), with marginally more men (56·8%) than women, and were prescribed an average 4·68 (SD 2·11) medications for their primary diagnosis of either chronic obstructive pulmonary disease or heart failure. Most participants (75·2%) were adherent to their prescribed medicines; however, medication knowledge was low [mean score 47·61 (SD 18·73) out of a potential 100]. Predictors of better adherence to medicines were patient-related: female gender and higher self-management capacity, and condition-related: heart failure diagnosis. Socioeconomic and treatment-related factors were not identified as independent predictors of medication adherence. Predictors of better medication knowledge were higher capacity for self-management, more concurrent conditions, younger age and taking fewer medicines.
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