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Adherence, hypertension

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Single adherence question predicts outcome

Journal of Clinical Nursing (2013) doi:10.1111/jocn.12471

Asking heart failure patients a single question about adherence once can predict the incidence of hospitalisation and mortality over the next year, a study found.

Researchers asked 592 heart failure patients (52% male; median age 61 years): 'Over the past seven days, how many times did you miss a dose of any of your heart medication?'. Seventy-two per cent reported not missing any doses. Of the 28% who were not fully adherent, 49% reported missing one dose in the last week, 38% missed two or three doses. The remainder missed at least four doses.

Over the next year, patients who adhered fully were 32% less likely to die or be hospitalised for any cause than those who were nonadherent (0.71 and 0.86 events per year respectively) after adjusting for confounders. Patients who adhered fully were 36% less likely to be hospitalised for heart failure (0.28 and 0.33 events per year respectively). Although a single question seems to predict adherence, the authors emphasised the importance of assessing adherence regularly.

Nurse-led clinics improve hypertension control

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