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Self-reported adherence with medication and cardiovascular disease outcomes in the Second Australian National Blood Pressure Study (ANBP2)

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Nelson, MR and Reid, CM and Ryan, PR and Willson, K and Yelland, L (2006) Self-reported adherence with medication and cardiovascular disease outcomes in the Second Australian National Blood Pressure Study (ANBP2). Medical Journal of Australia, 185 (9). pp. 487-489. ISSN 0025-729X

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Abstract

Objective: 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 nonadherent 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 MJA 2006; 185: 487–489 who are likely to benefit from medication adherence strategies.

Item Type: Article
Journal or Publication Title: Medical Journal of Australia
Page Range: pp. 487-489
ISSN: 0025-729X
Date Deposited: 22 Sep 2008 23:27
Last Modified: 18 Nov 2014 03:49
URI: http://eprints.utas.edu.au/id/eprint/7435
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