Make No Assumptions About Medication Adherence in Aging Heart Failure Patients

Americans make many assumptions about aging, and health care providers are no exception.

For example, many providers assume patients who have chronic heart failure (CHF) are more likely to be nonadherent to treatment plans if they are elderly. Since the incidence of CHF increases with age and accompanies high rates of hospitalization and mortality, understanding its unique adherence issues is important.

Like other chronic illnesses, medication nonadherence in CHF reduces quality of life and leads to poor clinical outcomes. CHF patients fill an average of 61 prescriptions annually, so they have ample opportunity to be confused, taxed with sorting prescriptions, and nonadherent to treatment.

Researchers analyzed existing clinical evidence to determine whether providers’ notions about age and adherence apply in CHF. After conducting a systematic search of published studies on medication adherence in adult patients with CHF, they searched for contributing factors with special attention to age.

Although the investigators found 1565 studies, only 17 met their inclusion criteria; however, these studies had enrolled more than 160,000 patients in total.

Among the studies, 7 found statistically significant relationships between age and medication adherence. Disproving the assumption that adherence declines with age, 6 studies determined the older CHF patients were, the more likely they were to adhere to prescribed medications.

A single study linked those aged 57 to 64 years to nonadherence to a single class of drugs: angiotensin-converting enzyme inhibitors. The remaining studies were unable to associate age with adherence.

This meta-analysis, which appears in the April 2015 issue of the International Journal of Cardiology, shows common assumptions are apparently incorrect. It indicates older patients are no less likely to adhere to medication than younger patients. In fact, younger patients may need more support and encouragement than older patients.

Pharmacists may need to devote a little more time to newly diagnosed CHF patients. It just might decrease hospitalizations and save lives.