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Characterizing weekly self-reported antihypertensive medication nonadherence across repeated occasions

Authors Voils C, King H, Neelon B, Hoyle R, Reeve B, Maciejewski M, Yancy Jr W

Received 15 January 2014

Accepted for publication 5 February 2014

Published 7 May 2014 Volume 2014:8 Pages 643—650


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Corrine I Voils,1,2 Heather A King,1 Brian Neelon,1,2 Rick H Hoyle,3 Bryce B Reeve,4 Matthew L Maciejewski,1,2 William S Yancy Jr1,2

1Health Services Research and Development, Durham Veterans Affairs Medical Center; 2Department of Medicine, Duke University; 3Department of Psychology and Neuroscience, Duke University; 4Department of Health Policy and Management, University of North Carolina at Chapel Hill, NC, USA

Background: Little is known about weekly variability in medication nonadherence both between and within persons.
Purpose: To characterize medication nonadherence across repeated, closely spaced occasions.
Methods: This prospective cohort study comprised four unannounced telephone assessment occasions, each separated by approximately 2 weeks. On each occasion, adult outpatients taking at least a single antihypertensive medication completed a measure of extent of, and reasons for, nonadherence.
Results: Two hundred and sixty-one participants completed 871 (83%) of 1,044 occasions. Nonadherence was reported on 152 (17.5%) of 871 occasions by 93 (36%) of 261 participants. The most commonly endorsed reasons for nonadherence were forgetting (39.5%), being busy (23.7%), and traveling (19.7%). Among 219 participants completing at least three occasions, 50% of the variability in extent of nonadherence was a result of within-person fluctuations, and 50% was a result of between-person differences.
Conclusion: Interventions to reduce nonadherence should be informed by variability in the extent of nonadherence and specific reasons for nonadherence.

Keywords: adherence, compliance, hypertension, intraindividual variability

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