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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
Authors/Creators:	Nelson, MR and Reid, CM and Ryan, PR and Willson, K and Yelland, L
Journal or Publication Title:	Medical Journal of Australia
ISSN:	0025-729X
Item Statistics:	View statistics for this item

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