Staying The Course And Staying Engaged: The Road To Medication Adherence

Abstract

<h3>Introduction</h3> Medication nonadherence in persons with heart failure (HF) is responsible for increased hospitalizations, morbidity, and mortality. Persons experiencing negative emotions, such as depression, are less motivated to take medications as prescribed, but very little is known about the influence of positive psychological characteristics (PPC), such as resilience and hope, on medication adherence in persons with HF. Activation, the degree to which individuals are motivated to engage self-management behaviors, has been identified as an important factor in chronic illness self-management. But there is little evidence about the role of activation in HF medication adherence. <h3>Aim</h3> The aim of this study was to investigate whether PPC (i.e., resilience, hope) and patient activation can explain or predict medication adherence in persons with HF. <h3>Methods</h3> A linear regression was calculated to predict medication adherence based on resilience, hope, and activation. Utilizing convenience sampling, 174 adults with HF completed the Patient Activation Measure (short-form) (PAM), 14-item Resilience Scale (short-form), Adult Hope Scale and Voils Self-Report of Medication Nonadherence Measurement (Part 1). Instruments were completed via the Qualtrics online platform. Linear regression models were used to show the relationships among the variables. <h3>Results</h3> Resilience, hope, and activation were positively correlated with medication adherence (p=.01). The model as a whole is significant <i>(F(3, 170)=7.398, p=.000, R² =.34)</i> and explains 15% of the variance in medication adherence scores. Resilience <i>(Beta= -.31, t(.02)=-3.0, p=.003)</i> and PAM <i>(Beta= -.17, t(.21)=-2.21, p=.028)</i> make a significant unique contribution to predicting medication adherence. <h3>Conclusions</h3> Resilience makes the strongest unique contribution to explaining medication adherence, followed by activation and hope. Resilient, hopeful, and activated persons with HF are more likely to take medications as prescribed. Thus, enhancing PPC and activation in persons with HF may result in improved medication adherence.