Association between perceived life chaos and medication adherence in a postmyocardial infarction population.

Zullig LL, Shaw RJ, Crowley MJ, Lindquist J, Grambow SC, Peterson E, Shah BR, Bosworth HB. Association between perceived life chaos and medication adherence in a postmyocardial infarction population. Circulation. Cardiovascular quality and outcomes. 2013 Nov 12; 6(6):619-25.

Related HSR&D Project(s)

• CDA 13-025 – Colorectal Cancer Survivorship Care in the Veterans Affairs Healthcare System
• CDA 13-261 – Tailored, eHealth-based Management for Persistent Poorly-Controlled Diabetes
• RCS 08-027 – Research Career Scientist Award

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:

BACKGROUND: The benefits of medication adherence to control cardiovascular disease (CVD) are well defined, yet multiple studies have identified poor adherence. The influence of life chaos on medication adherence is unknown. Because this is a novel application of an instrument, our preliminary objective was to understand patient factors associated with chaos. The main objective was to evaluate the extent to which an instrument designed to measure life chaos is associated with CVD-medication nonadherence. METHODS AND RESULTS: Using baseline data from an ongoing randomized trial to improve postmyocardial infarction (MI) management, multivariable logistic regression identified the association between life chaos and CVD-medication nonadherence. Patients had hypertension and a myocardial infarction in the past 3 years (n = 406). Nearly 43% reported CVD-medication nonadherence in the past month. In simple linear regression, the following were associated with higher life chaos: medication nonadherence (ß = 1.86; 95% confidence interval [CI], 0.96-2.76), female sex (ß = 1.22; 95% CI [0.22-2.24]), minority race (ß = 1.72; 95% CI [0.78-2.66]), having less than high school education (ß = 2.05; 95% CI [0.71-3.39]), low health literacy (ß = 2.06; 95% CI [0.86-3.26]), and inadequate financial status (ß = 1.93; 95% CI [0.87-3.00]). Being married (ß = -2.09, 95% CI [-3.03 to -1.15]) was associated with lower life chaos. As chaos quartile increased, patients exhibited more nonadherence. In logistic regression, adjusting for sex, race, marital status, employment, education, health literacy, and financial status, a 1-unit life chaos increase was associated with a 7% increase (odds ratio, 1.07; 95% CI [1.02-1.12]) in odds of reporting medication nonadherence. CONCLUSIONS: Our results suggest that life chaos may be an important determinant of medication adherence. Life chaos screenings could identify those at risk for nonadherence. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT000901277.