Abstract 12038: A Family-focused and Literacy-sensitive Intervention to Improve Medication Adherence in Patients With Heart Failure

Abstract

Background: Medication nonadherence contributes to rehospitalization and death in heart failure (HF) patients, yet there is no intervention that improves and sustains adherence after intervention completion. Objective: To address the need for a more effective intervention, we combined a literacy sensitive approach that also incorporated family support in an educational counseling intervention. The purpose of the study was to pilot-test the effects of a fam ily-focused, lit eracy-sensitive ( FamLit ) intervention on improving and sustaining medication adherence in HF patients. Methods: A randomized controlled pilot trial was conducted on 43 HF patients and their family members (dyads) who were assigned to the FamLit intervention group or usual care attention-control group. All dyads had an in-person session at baseline and received bi-weekly phone booster calls for the 3 month intervention. The Medication Event Monitoring System (MEMS) was used to measure medication adherence continuously for 6 months (from baseline). Repeated measures analysis of variance (ANOVA) was used to analyze the data. Results: No differences on demographic and clinical factors between groups at baseline. After the intervention, patients in the FamLit group (n=24) had better medication adherence compared to the control group (n=19) as measured by the MEMS (84.96% vs. 79.9%). Repeated measures ANOVA showed that there was a significant group by time interaction (F=7.158, p=.011). Improvement of medication adherence was sustained from 3 to 6 months in the intervention group (84.96% to 84.67%, Figure) while medication adherence decreased in the control group (79.9% to 69.96%), reflecting the natural trajectory of medication adherence. Conclusion: Incorporating family support and providing easy-to-read educational material to both HF patients and their caregivers enhances medication adherence during the intervention and sustains adherence 3 months after intervention completion.