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Cited by 48Medication Adherence and ComplianceCardiac Health and Mental HealthAtrial Fibrillation Management and Outcomes

Association Between Perceived Life Chaos and Medication Adherence in a Postmyocardial Infarction Population

Zullig, Leah L., Shaw, Ryan J., Crowley, Matthew J., Lindquist, Jennifer, Grambow, Steven C., Peterson, Eric, Shah, Bimal R., Bosworth, Hayden B.·2013·Circulation: Cardiovascular Quality and Outcomes
DOI 10.1161/circoutcomes.113.000435
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Abstract

Background—: The benefits of medication adherence to control cardiovascular disease (CVD) are well defined, yet multiple studies have identified poor adherence. The influence of life chaos on medication adherence is unknown. Because this is a novel application of an instrument, our preliminary objective was to understand patient factors associated with chaos. The main objective was to evaluate the extent to which an instrument designed to measure life chaos is associated with CVD-medication nonadherence. Methods and Results—: Using baseline data from an ongoing randomized trial to improve postmyocardial infarction (MI) management, multivariable logistic regression identified the association between life chaos and CVD-medication nonadherence. Patients had hypertension and a myocardial infarction in the past 3 years (n=406). Nearly 43% reported CVD-medication nonadherence in the past month. In simple linear regression, the following were associated with higher life chaos: medication nonadherence (β=1.86; 95% confidence interval [CI], 0.96–2.76), female sex (β=1.22; 95% CI [0.22–2.24]), minority race (β=1.72; 95% CI [0.78–2.66]), having less than high school education (β=2.05; 95% CI [0.71–3.39]), low health literacy (β=2.06; 95% CI [0.86–3.26]), and inadequate financial status (β=1.93; 95% CI [0.87–3.00]). Being married (β=−2.09, 95% CI [−3.03 to −1.15]) was associated with lower life chaos. As chaos quartile increased, patients exhibited more nonadherence. In logistic regression, adjusting for sex, race, marital status, employment, education, health literacy, and financial status, a 1-unit life chaos increase was associated with a 7% increase (odds ratio, 1.07; 95% CI [1.02–1.12]) in odds of reporting medication nonadherence. Conclusions—: Our results suggest that life chaos may be an important determinant of medication adherence. Life chaos screenings could identify those at risk for nonadherence. Clinical Trial Registration—: URL: http://www.clinicaltrials.gov . Unique identifier: NCT000901277

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Crossref · 10.1161/circoutcomes.113.000435

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Authors
Zullig, L. L., Shaw, R. J., Crowley, M. J., Lindquist, J., Grambow, S. C., Peterson, E., Shah, B. R., & Bosworth, H. B.
Affiliations
Duke University (US)
ORCID
Venue
Circulation: Cardiovascular Quality and Outcomes
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2013-11
Volume
6
Issue
6
Pages
619-625
ISSN
  • 1941-7705 (ISSN-L)
  • 1941-7713
DOI
10.1161/circoutcomes.113.000435
OpenAlex
W2170380367
Cited by
48
References
24
Citations by year
2025: 1 · 2024: 1 · 2023: 7 · 2022: 4 · 2021: 8 · 2020: 3 · 2019: 5 · 2018: 3 · 2017: 7 · 2016: 4 · 2015: 3 · 2014: 1 · 2013: 1
FWCI
2.55
Type
journal article
Language
en
Open access
closed
Locations
  • Circulation Cardiovascular Quality and Outcomes (publishedVersion)
  • PubMed (publishedVersion)
Funders
Agency for Healthcare Research and Quality (U19HS021092)
Topics
  • Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
Keywords
medication adherence, medication non-adherence, cardiovascular disease, myocardial infarction, health literacy, financial conditions, marital status, socioeconomic factors, patient-reported outcomes, hypertension, educational attainment, sex differences, quality of life, social support
MeSH terms
Aged, Cross-Sectional Studies, Demography, Female, Humans, Life Style, Male, Middle Aged, Myocardial Infarction, North Carolina, Patient Compliance, Perception, Risk, Sex Factors, Time Factors, Drug Monitoring, Nonlinear Dynamics, Racial Groups

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