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Measuring the adherence to medication of elderly patients with heart failure: is there a gold standard?

Measuring the adherence to medication of elderly patients with heart failure: is there a gold standard?
Measuring the adherence to medication of elderly patients with heart failure: is there a gold standard?
ACE inhibitors and loop diuretics are treatments of first choice for heart failure, but patients must take their medications regularly to achieve maximum benefit. Adherence is commonly assessed using pill counts, self-report or electronic monitoring, with the latter widely considered the ‘gold standard’. We assessed the concordance of these three methods in a sample of 52 elderly patients with heart failure over a six-week period. Substantial differences in adherence were found between the three methods. Adherence by self-report was very high for both ACE-I and diuretic, with little between-person variation. This was, however, uncorroborated by pill count and electronic monitoring. Closer examination of the electronic record suggested that the mean level of adherence overlooked patterns of openings more consistent with adherent behaviour. There seems to be no gold standard for measurement of adherence in this population.

heart failure, adherence, compliance
0167-5273
122-123
Smith, Helen
42562879-cabb-497a-9209-ae8c6530b37d
Hankins, Matthew
ce4b7d68-3320-4af4-9dd7-3537a4b07219
Hodson, Andrew
3cd52a6e-a9d4-4e5a-afac-00e2533f0f76
George, Charles
82bae1e0-b46e-4092-94a4-afb345f913a8
Smith, Helen
42562879-cabb-497a-9209-ae8c6530b37d
Hankins, Matthew
ce4b7d68-3320-4af4-9dd7-3537a4b07219
Hodson, Andrew
3cd52a6e-a9d4-4e5a-afac-00e2533f0f76
George, Charles
82bae1e0-b46e-4092-94a4-afb345f913a8

Smith, Helen, Hankins, Matthew, Hodson, Andrew and George, Charles (2010) Measuring the adherence to medication of elderly patients with heart failure: is there a gold standard? International Journal of Cardiology, 145 (1), 122-123. (doi:10.1016/j.ijcard.2009.06.025). (PMID:19615767)

Record type: Article

Abstract

ACE inhibitors and loop diuretics are treatments of first choice for heart failure, but patients must take their medications regularly to achieve maximum benefit. Adherence is commonly assessed using pill counts, self-report or electronic monitoring, with the latter widely considered the ‘gold standard’. We assessed the concordance of these three methods in a sample of 52 elderly patients with heart failure over a six-week period. Substantial differences in adherence were found between the three methods. Adherence by self-report was very high for both ACE-I and diuretic, with little between-person variation. This was, however, uncorroborated by pill count and electronic monitoring. Closer examination of the electronic record suggested that the mean level of adherence overlooked patterns of openings more consistent with adherent behaviour. There seems to be no gold standard for measurement of adherence in this population.

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Published date: 5 November 2010
Keywords: heart failure, adherence, compliance

Identifiers

Local EPrints ID: 187309
URI: http://eprints.soton.ac.uk/id/eprint/187309
ISSN: 0167-5273
PURE UUID: 5101cb8a-a02d-4262-8dcf-f1ab00f2abce

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Date deposited: 17 May 2011 12:34
Last modified: 14 Mar 2024 03:23

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Contributors

Author: Helen Smith
Author: Matthew Hankins
Author: Andrew Hodson
Author: Charles George

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