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Improving Medication Adherence in Coronary Heart Disease

  • Psychological Aspects of Cardiovascular Diseases (A Steptoe, Section Editor)
  • Published:
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Abstract

Purpose of Review

The purpose of this review was to synthesize research findings from recently published randomized controlled trials (RCTs) targeting any phase of medication adherence, from initiation to discontinuation, among patients with coronary heart disease (CHD).

Recent Findings

We identified successful strategies and promising practices for improving medication adherence among patients diagnosed with CHD. Consistent intervention strategies included the following: (1) facilitating patient-provider communication, (2) using mHealth technologies with emphasis on two-way communication, (3) providing patient education in tandem with lifestyle and behavioral counseling, and (4) providing psychosocial support. Regarding medication adherence phases, all studies examined implementation (i.e., taking medications as prescribed over time) and one also addressed treatment initiation (i.e., beginning a new medication). None identified addressed discontinuation. Studies varied by use of objective, self-report, and a combination of outcome measures with a greater number reporting only subjective measures of adherence. Key findings remained mixed in supporting specific intervention designs or delivery formats.

Summary

This review addresses available data of promising practices for improving CHD medication adherence. Future studies are needed to examine intervention effectiveness, scalability, and durability of observed outcome effects.

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Abbreviations

ACE:

Angiotensin converting enzyme inhibitors

CHD:

Coronary heart disease

MEMS:

Medication Event Monitoring System

mHealth:

Mobile health

MI:

Myocardial infarction

MMAS:

Morisky Medication Adherence Scale

PCI:

Percutaneous coronary intervention

RCT:

Randomized controlled trial

SMS:

short message service or text message

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Acknowledgements

Dr. Zullig is supported by a VA Health Services Research and Development (HSR&D) Career Development Award (CDA 13-025). Dr. Bosworth is supported a VA Senior Career Scientist award from the VA HSR&D (VA HSR&D-8-297). This work was supported by the Center of Innovation for Health Services Research in Primary Care (CIN 13-410) at the Durham VA Health Care System.

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Authors and Affiliations

  1. Center for Health Services Research in Primary Care, Durham Veterans Affairs Health Care System, 411 West Chapel Hill Street, Suite 600, Durham, NC, 27701, USA

    Leah L. Zullig & Hayden B. Bosworth

  2. Department of Population Health Sciences, Duke University, Durham, NC, USA

    Leah L. Zullig & Hayden B. Bosworth

  3. Geriatric, Research, Education and Clinical Center (GRECC), Durham Veterans Affairs Health Care System, 508 Fulton Street, Durham VA Health Care System, GRECC (182), Durham, NC, 27705, USA

    Katherine Ramos

  4. Center for Aging and Human Development, Duke University, Durham, NC, USA

    Katherine Ramos

  5. School of Nursing, Duke University, Durham, NC, USA

    Hayden B. Bosworth

  6. Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA

    Hayden B. Bosworth

Authors
  1. Leah L. Zullig
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  2. Katherine Ramos
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  3. Hayden B. Bosworth
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Corresponding author

Correspondence to Hayden B. Bosworth.

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Conflict of Interest

Leah L. Zullig reports grants from PhRMA Foundation; a salary from the U.S. Department of Veterans Affairs, and from Duke University; and other from Novartis.

Hayden B. Bosworth reports grants and personal fees from Sanofi; personal fees from Genentech, Boehringer Ingelheim, and Ostuku; and grants from Improved Patient Outcomes and Johnson & Johnson.

Katherine Ramos declares that she has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Psychological Aspects of Cardiovascular Diseases

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Zullig, L.L., Ramos, K. & Bosworth, H.B. Improving Medication Adherence in Coronary Heart Disease. Curr Cardiol Rep 19, 113 (2017). https://doi.org/10.1007/s11886-017-0918-y

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  • DOI: https://doi.org/10.1007/s11886-017-0918-y

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