Abstract 19495: Compensatory Strategies Improve Medication Adherence in Heart Failure Patients With Mild Global Cognitive Impairment

Abstract

Introduction: Mild cognitive impairment is common in patients with HF and is linked to poor medication adherence. Poor medication adherence is associated with higher mortality and hospitalizations. Medication adherence strategies to compensate for cognitive impairment are not well understood. The purpose of this secondary analysis is to identify the type and frequency of compensatory strategies used by patients with HF and mild cognitive impairment and to determine if compensatory strategy use is associated with medication adherence. Methods and Results: The parent study was a longitudinal descriptive study (N=379) to determine the relationships among cognitive impairment and self-management. The Modified Mental Status (3MS), a global measure of cognition and an electronic pill box (Medsignals) were used. A subsample of 156 patients with mild to moderate global cognitive impairment was selected based on a 3MS of less than 90. The frequencies of four compensatory strategies use were: pillbox (n=85, 57%), family reminders (n=17, 11%), reminders including calendars and alarms (n=17, 11%), and combining administration with other tasks (n=51, 33%). An independent samples t-test was performed to test the difference in medication adherence between persons that did and did not use each compensatory strategy. Pillbox use was associated with medication adherence (p<.05). The group that used a pillbox (n=80) had a mean medication adherence of 82.5%, while no pillbox use (n=90) had a mean of 74.8% No other compensatory strategies were related to better medication adherence. Conclusion: In clinical practice, global cognition screening and education on pillbox use to improve medication adherence is recommended. Although other compensatory strategies did not have a significant impact on medication adherence, more research is need to understand compensatory strategies to help patients with mild cognitive impairment improve medication adherence.