Health-Related Quality of Life Is a Mediator of the Relationship Between Medication Adherence and Cardiac Event-Free Survival in Patients with Heart Failure

Jia Rong Wu; Debra K. Moser

doi:10.1016/j.cardfail.2021.03.004

Health-Related Quality of Life Is a Mediator of the Relationship Between Medication Adherence and Cardiac Event-Free Survival in Patients with Heart Failure

Jia Rong Wu, Debra K. Moser

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

Background: Health-related quality of life (HRQOL) is an important patient-reported outcome that is related to medication adherence, hospitalization and death. The nature of the relationships among medication adherence, HRQOL, and hospitalization and death is unknown. We sought to determine the relationships among medication adherence, HRQOL, and cardiac event-free survival in patients with heart failure. Methods and Results: We enrolled 218 patients with heart failure. Patients’ medication adherence was measured objectively using the Medication Event Monitoring System. HRQOL was assessed using the Minnesota Living with Heart Failure Questionnaire. Patients were followed for up to 3.5 years to collect hospitalization and mortality data. Mediation analysis was used to determine the nature of the relationships among the variables. Patients with better medication adherence had better HRQOL (P = .014). Medication adherence and HRQOL were associated with cardiac event-free survival (both P < .05). Patients with medication nonadherence were 1.86 times more likely to experience a cardiac event than those with better medication adherence (P = .038). Medication adherence was not associated with cardiac event-free survival after entering HRQOL in the model (P = .118), indicating mediation by HRQOL of the relationship between medication adherence and cardiac event-free survival. Conclusions: HRQOL mediated the relationship between medication adherence and cardiac event-free survival. It is important to assess medication adherence and HRQOL regularly and develop interventions to improve medication adherence and HRQOL to decrease hospitalization and mortality in patients with heart failure.

Original language	English
Pages (from-to)	848-856
Number of pages	9
Journal	Journal of Cardiac Failure
Volume	27
Issue number	8
DOIs	https://doi.org/10.1016/j.cardfail.2021.03.004
State	Published - Aug 2021

Bibliographical note

Funding Information:
Supported by funding from the Philips Medical-American Association of Critical Care Nurses Outcomes Grant, American Heart Association Great River Affiliate Post-doctoral Fellowship to Jia-Rong Wu and by funding from the National Institute of Nursing Research (NINR): K23NR014489 (J. Wu, PI), University of Kentucky Clinical and Translational Science Center (M01RR02602). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.

Publisher Copyright:
© 2021 Elsevier Inc.

Keywords

Medication adherence
event-free survival
health-related quality of life
heart failure

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1016/j.cardfail.2021.03.004

Cite this

@article{0c2014d4c5b34a31b6d8a13e8aabe1f1,

title = "Health-Related Quality of Life Is a Mediator of the Relationship Between Medication Adherence and Cardiac Event-Free Survival in Patients with Heart Failure",

abstract = "Background: Health-related quality of life (HRQOL) is an important patient-reported outcome that is related to medication adherence, hospitalization and death. The nature of the relationships among medication adherence, HRQOL, and hospitalization and death is unknown. We sought to determine the relationships among medication adherence, HRQOL, and cardiac event-free survival in patients with heart failure. Methods and Results: We enrolled 218 patients with heart failure. Patients{\textquoteright} medication adherence was measured objectively using the Medication Event Monitoring System. HRQOL was assessed using the Minnesota Living with Heart Failure Questionnaire. Patients were followed for up to 3.5 years to collect hospitalization and mortality data. Mediation analysis was used to determine the nature of the relationships among the variables. Patients with better medication adherence had better HRQOL (P = .014). Medication adherence and HRQOL were associated with cardiac event-free survival (both P < .05). Patients with medication nonadherence were 1.86 times more likely to experience a cardiac event than those with better medication adherence (P = .038). Medication adherence was not associated with cardiac event-free survival after entering HRQOL in the model (P = .118), indicating mediation by HRQOL of the relationship between medication adherence and cardiac event-free survival. Conclusions: HRQOL mediated the relationship between medication adherence and cardiac event-free survival. It is important to assess medication adherence and HRQOL regularly and develop interventions to improve medication adherence and HRQOL to decrease hospitalization and mortality in patients with heart failure.",

keywords = "Medication adherence, event-free survival, health-related quality of life, heart failure",

author = "Wu, {Jia Rong} and Moser, {Debra K.}",

note = "Funding Information: Supported by funding from the Philips Medical-American Association of Critical Care Nurses Outcomes Grant, American Heart Association Great River Affiliate Post-doctoral Fellowship to Jia-Rong Wu and by funding from the National Institute of Nursing Research (NINR): K23NR014489 (J. Wu, PI), University of Kentucky Clinical and Translational Science Center (M01RR02602). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. Publisher Copyright: {\textcopyright} 2021 Elsevier Inc.",

year = "2021",

month = aug,

doi = "10.1016/j.cardfail.2021.03.004",

language = "English",

volume = "27",

pages = "848--856",

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TY - JOUR

T1 - Health-Related Quality of Life Is a Mediator of the Relationship Between Medication Adherence and Cardiac Event-Free Survival in Patients with Heart Failure

AU - Wu, Jia Rong

AU - Moser, Debra K.

N1 - Funding Information: Supported by funding from the Philips Medical-American Association of Critical Care Nurses Outcomes Grant, American Heart Association Great River Affiliate Post-doctoral Fellowship to Jia-Rong Wu and by funding from the National Institute of Nursing Research (NINR): K23NR014489 (J. Wu, PI), University of Kentucky Clinical and Translational Science Center (M01RR02602). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. Publisher Copyright: © 2021 Elsevier Inc.

PY - 2021/8

Y1 - 2021/8

N2 - Background: Health-related quality of life (HRQOL) is an important patient-reported outcome that is related to medication adherence, hospitalization and death. The nature of the relationships among medication adherence, HRQOL, and hospitalization and death is unknown. We sought to determine the relationships among medication adherence, HRQOL, and cardiac event-free survival in patients with heart failure. Methods and Results: We enrolled 218 patients with heart failure. Patients’ medication adherence was measured objectively using the Medication Event Monitoring System. HRQOL was assessed using the Minnesota Living with Heart Failure Questionnaire. Patients were followed for up to 3.5 years to collect hospitalization and mortality data. Mediation analysis was used to determine the nature of the relationships among the variables. Patients with better medication adherence had better HRQOL (P = .014). Medication adherence and HRQOL were associated with cardiac event-free survival (both P < .05). Patients with medication nonadherence were 1.86 times more likely to experience a cardiac event than those with better medication adherence (P = .038). Medication adherence was not associated with cardiac event-free survival after entering HRQOL in the model (P = .118), indicating mediation by HRQOL of the relationship between medication adherence and cardiac event-free survival. Conclusions: HRQOL mediated the relationship between medication adherence and cardiac event-free survival. It is important to assess medication adherence and HRQOL regularly and develop interventions to improve medication adherence and HRQOL to decrease hospitalization and mortality in patients with heart failure.

AB - Background: Health-related quality of life (HRQOL) is an important patient-reported outcome that is related to medication adherence, hospitalization and death. The nature of the relationships among medication adherence, HRQOL, and hospitalization and death is unknown. We sought to determine the relationships among medication adherence, HRQOL, and cardiac event-free survival in patients with heart failure. Methods and Results: We enrolled 218 patients with heart failure. Patients’ medication adherence was measured objectively using the Medication Event Monitoring System. HRQOL was assessed using the Minnesota Living with Heart Failure Questionnaire. Patients were followed for up to 3.5 years to collect hospitalization and mortality data. Mediation analysis was used to determine the nature of the relationships among the variables. Patients with better medication adherence had better HRQOL (P = .014). Medication adherence and HRQOL were associated with cardiac event-free survival (both P < .05). Patients with medication nonadherence were 1.86 times more likely to experience a cardiac event than those with better medication adherence (P = .038). Medication adherence was not associated with cardiac event-free survival after entering HRQOL in the model (P = .118), indicating mediation by HRQOL of the relationship between medication adherence and cardiac event-free survival. Conclusions: HRQOL mediated the relationship between medication adherence and cardiac event-free survival. It is important to assess medication adherence and HRQOL regularly and develop interventions to improve medication adherence and HRQOL to decrease hospitalization and mortality in patients with heart failure.

KW - Medication adherence

KW - event-free survival

KW - health-related quality of life

KW - heart failure

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U2 - 10.1016/j.cardfail.2021.03.004

DO - 10.1016/j.cardfail.2021.03.004

M3 - Article

C2 - 34364662

AN - SCOPUS:85111946191

SN - 1071-9164

VL - 27

SP - 848

EP - 856

JO - Journal of Cardiac Failure

JF - Journal of Cardiac Failure

IS - 8

ER -

Health-Related Quality of Life Is a Mediator of the Relationship Between Medication Adherence and Cardiac Event-Free Survival in Patients with Heart Failure

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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