Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/35627
Type: Journal article
Title: Self-reported adherence with medication and cardiovascular disease outcomes in the Second Australian National Blood Pressure Study (ANBP2)
Author: Nelson, M.
Reid, C.
Ryan, P.
Willson, K.
Yelland, L.
Citation: Medical Journal of Australia, 2006; 185(9):487-489
Publisher: Australasian Medical Publishing Company
Issue Date: 2006
ISSN: 0025-729X
1326-5377
Statement of
Responsibility: 
Mark R Nelson, Christopher M Reid, Philip Ryan, Kristyn Willson and Lisa Yelland, on behalf of the ANBP2 Management Committee
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 non-adherent 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 who are likely to benefit from medication adherence strategies.
Keywords: Humans; Cardiovascular Diseases; Hypertension; Antihypertensive Agents; Treatment Outcome; Health Surveys; Risk Factors; Cohort Studies; Treatment Refusal; Aged; Aged, 80 and over; Australia; Female; Male; Self-Assessment
Description: The document attached has been archived with permission from the editor of the Medical Journal of Australia. An external link to the publisher’s copy is included.
RMID: 0020061951
Published version: http://www.mja.com.au/public/issues/185_09_061106/nel10178_fm.html
Appears in Collections:Public Health publications

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