Examining adherence to medication in patients with persistent atrial fibrillation: The role of medication beliefs, attitudes and depression.

Journal article


Taylor, Elaina C., Hughes, Lyndsay D, O'Neill, Mark and Bennett, Peter 2020. Examining adherence to medication in patients with persistent atrial fibrillation: The role of medication beliefs, attitudes and depression. Journal of Cardiovascular Nursing. https://doi.org/10.1097/JCN.0000000000000650
AuthorsTaylor, Elaina C., Hughes, Lyndsay D, O'Neill, Mark and Bennett, Peter
Abstract

This study examined whether beliefs about medicines, drug attitudes, and depression independently predicted anticoagulant and antiarrhythmic adherence (focusing on the implementation phase of nonadherence) in patients with atrial fibrillation(AF). This cross-sectional study was part of a larger longitudinal study. Patients with AF (N = 118) completed the Patient Health Questionnaire-8. The Beliefs about Medicines Questionnaire, Drug Attitude Inventory, and Morisky-Green-Levine Medication Adherence Scale (self-report adherence measure), related to anticoagulants and antiarrhythmics, were also completed. Correlation and logistic regression analyses were conducted. There were no significant differences in non-adherence to anticoagulants or antiarrhythmics. Greater concerns (r = 0.23, P = .01) were significantly, positively associated with anticoagulant nonadherence only. Depression and drug attitudes were not significantly associated with anticoagulant/antiarrhythmic adherence. Predictors reliably distinguished adherers and non-adherers to anticoagulant medication in the regression model, explaining 14% of the variance, but only concern beliefs (odds ratio, 1.20) made a significant independent contribution to prediction (χ2 =11.40, P=.02,with df = 4). When entered independently into a regression model, concerns (odds ratio, 1.24) significantly explained 10.3% of the variance (χ2 = 7.97, P = .01, with df = 1). Regressions were not significant for antiarrhythmic medication (P = .30). Specifying medication type is important when examining nonadherence in chronic conditions. Concerns about anticoagulants, rather than depression, were significantly associated with non-adherence to anticoagulants but not antiarrhythmics. Anticoagulant concerns should be targeted at AF clinics, with an aim to reduce nonadherence and potentially modifiable adverse outcomes such as stroke.

Keywordsanticoagulants, antiarrhythmic agents, atrial fibrillation, attitudes, depression, health knowledge, medication adherence.
Year2020
JournalJournal of Cardiovascular Nursing
PublisherWolters Kluwer
ISSN0889-4655
1550-5049
Digital Object Identifier (DOI)https://doi.org/10.1097/JCN.0000000000000650
Web address (URL)http://hdl.handle.net/10545/624974
hdl:10545/624974
Publication dates21 Feb 2020
Publication process dates
Deposited10 Jul 2020, 10:29
Accepted01 Feb 2020
ContributorsKing's College London
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