Cognitive impairment and medication adherence in outpatients with heart failure.

Hawkins LA, Kilian S, Firek A, Kashner TM, Firek CJ, Silvet H. Cognitive impairment and medication adherence in outpatients with heart failure. Heart & lung : the journal of critical care. 2012 Nov 1; 41(6):572-82.

Related HSR&D Project(s)

• RRP 09-166 – Cognitive Impairment as a Risk for the Admission-Readmission Cycle Seen in Veterans with Heart Failure: Closing the Adherence Gap

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information vaww.hsrd.research.va.gov/dimensions/

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.    Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions

Search for Abstract from PubMed

---

Abstract:

OBJECTIVES: The study objectives were (a) to describe the prevalence and severity of cognitive impairment (CI) in an outpatient veteran population with heart failure (HF), (b) to describe the cognitive domains affected in those subjects found to have CI, (c) to examine clinical and demographic variables that may be associated with CI, and (d) to determine the relationship between CI and medication adherence (MA). We hypothesized that CI is a prevalent condition in veterans with HF and is associated with poorer MA. Adherence to therapy is essential for successful outcomes. CI may affect adherence; little is known about CI in veterans with HF or the effect of CI on MA. METHODS: We enrolled 251 veteran outpatients with HF. Subjects were screened for CI; adherence was determined by pill counts. Subjects with CI underwent further neuropsychologic testing. RESULTS: Unrecognized CI was found in 58% of subjects. Verbal learning, immediate memory, and delayed verbal memory were most impaired. CI was significantly associated with poorer MA. Variables associated with CI included age, African-American race, depression, use of alcohol, and nonparticipation in pill count. CONCLUSION: Unrecognized CI was prevalent and associated with poorer MA. We propose routine screening for CI in patients with HF.