Directly Measured Adherence to Treatment in Chronic Heart Failure: LEVEL-CHF Registry
Language English Country United States Media print-electronic
Document type Journal Article
PubMed
33781390
DOI
10.1016/j.amjms.2020.12.004
PII: S0002-9629(20)30537-1
Knihovny.cz E-resources
- Keywords
- Adherence, Compliance, Heart failure, Pharmacotherapy, Serum drug levels,
- MeSH
- Mineralocorticoid Receptor Antagonists therapeutic use MeSH
- Angiotensin Receptor Antagonists therapeutic use MeSH
- Adrenergic beta-Antagonists therapeutic use MeSH
- Chronic Disease drug therapy MeSH
- Assessment of Medication Adherence * MeSH
- Angiotensin-Converting Enzyme Inhibitors therapeutic use MeSH
- Middle Aged MeSH
- Humans MeSH
- Prospective Studies MeSH
- Aged MeSH
- Heart Failure drug therapy MeSH
- Age Factors MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
- Names of Substances
- Mineralocorticoid Receptor Antagonists MeSH
- Angiotensin Receptor Antagonists MeSH
- Adrenergic beta-Antagonists MeSH
- Angiotensin-Converting Enzyme Inhibitors MeSH
BACKGROUND: Currently, most available data on the medication adherence of patients with chronic heart failure are based on indirect methods. We examined the level of adherence to medical therapy using a direct method - serum drug level testing. METHODS: We carried out a prospective single-centre registry of patients with chronic heart failure (LEVEL-CHF registry), in whom we analysed serum levels of the medications prescribed for the treatment of heart failure: angiotensin converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists. We labelled a patient as non-adherent if at least one serum level of a prescribed drug was unmeasurable (below the detection limit). Patients with all tested drugs identifiable in serum were labelled as adherent. We enrolled 274 patients (208 men and 66 women) mean age 62 years. RESULTS: 82.5% of patients were adherent and 17.5% non-adherent to prescribed medications. 3.6% were completely non-adherent without any detectable drugs in serum. Patients aged <60 years were more likely to be non-adherent than older patients (OR 2.15). No other clinical or laboratory parameters predicted non-adherence. CONCLUSIONS: A significant proportion of outpatients with chronic heart failure were non-adherent to treatment when assessed by a direct method of serum drug level testing. Non-adherence was more likely in younger patients.
Department of Biostatistics and Analysis Masaryk University Brno Czech Republic
Department of Forensic Medicine Olomouc University Hospital Olomouc Czech Republic
Faculty of Medicine and Dentistry Palacky University Olomouc Czech Republic
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