Journal
HEART & LUNG
Volume 45, Issue 6, Pages 468-474Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.hrtlng.2016.08.003
Keywords
Medication adherence; Self-care; Common sense model; Heart failure; Qualitative symptoms
Funding
- SIGMA Theta Tau International Honor Society of Nursing
- NIOSH Education and Research Center for Occupational Safety and Health at the Johns Hopkins Bloomberg School of Public Health [T42OH0087428-02]
- Kynett Foundation
- University of Pennsylvania Institute on Aging
- New York University Provost University Challenge Research Fund
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Objective: To explore factors contributing to intentional and unintentional medication nonadherence in adults with chronic heart failure (HF). Background: Medication nonadherence is prevalent in HF but the factors contributing to it are not well understood. Methods: This secondary data analysis of qualitative data explored narrative accounts about medication adherence from four previous studies (N = 112). The Necessity Concerns Framework derived from the Common Sense Model (CSM) of Self-Regulation guided the interpretation of themes. Results: In this diverse sample (39% Black, 6% Hispanic, 63% male; mean age 59 15 years), 90% reported at least intermittent nonadherence. For many (60%), missing medication was unintentional but 27% reported intentional nonadherence. Four interconnected patterns of behavior emerged: 1) rarely non adherent, 2) frequently nonadherent, 3) intentionally nonadherent, and 4) reformed nonadherent. Misperceptions about HF, beliefs, concerns, and contextual factors contributed to both intentional and unintentional nonadherence. Conclusion: Medication nonadherence is prevalent in HF and influenced by modifiable factors. (C) 2016 Elsevier Inc. All rights reserved.
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