A qualitative secondary data analysis of intentional and unintentional medication nonadherence in adults with chronic heart failure

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.