PURPOSE: Little is known about complexity in medication-taking behaviors in heart failure(HF)patients.
METHODS: Sixty NYHA class II and III HF patients were investigated on medication complexity(items on frequency,special instructions related to medications and behaviors). Demographic and clinical factors(comorbidities,hospitalizations,length of time with HF,NYHA class) and medications were studeid.
RESULTS: 36/60(60%)were in NYHA class II,mean age 78.6(SD 8.6),40.0% femele,25% were living alone,55% had completed high school or higher. The mean duration of HF was 9.1 years(SD 6.5)(median 8.0),45/60(75.0%) had at least one hospitalization (mean 1.2,SD 0.9,range 1 to 3). 26/60(48.7%) and 16/60(26.7%) had one, and 2 and more hospitalizations,respectively. All of 60 patients had at least one comorbidity,and 21/60(35.0%),18/60(30.0%) and 21/60(35.0%) had one,2,and 3 and more comorbities,respectively.(e.g.,diabetes mellitus, hypertension, ischemic heart disease, atrial fibrillation, cerebrovascular disease). Patients took a mean of 8.8(SD 2.8, range 2 to 16) different medications daily. Medicines were taken once,twice,and three and more times per day by 26.7%,23.3% and 46.7%,respectively. 21/60(36.5%) took one dose preparations. 55/60(91.7%) had to perform at least one behavior specifically required for taking medications(mean1.6 SD o.9,range 1 to 5).23/60(38.3%),24/60(40.0%) and 8/60(13.4%) required one,2,and three and more behaviors,respectively.(e.g., take at fasting time in the morning, immediately before each meal, immediately after rising, special food restriction. every other day, break in half, take with food,take other medications for side effects). Refill of prescriptions were required at varying times with mean 27.5 days (SD 3.0, range 14 to35)
CONCLUSIONS: Prescriptions were overly complex medication regimens with multiple and much medicines.
CLINICAL IMPLICATIONS: The results may be useful to evaluate the regimen of medication taking behaviors and reducing burden and improvinga dherence.
DISCLOSURE: The following authors have nothing to disclose: Nobuyuki Anzai, Rieko Mitobe, Makiko Anzai, Kei Goto
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