Association between adherence to diuretic therapy and health care utilization in patients with heart failure

Michelle A. Chui, Melissa Deer, Susan Pressler, Wanzhu Tu, Stacey Oury, Craig Brater, Michael Murray

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Study Objective. To determine the relationship between adherence to diuretic therapy and health care utilization. Design. Prospective, observational study. Setting. University-affiliated medical center. Patients. Forty-two patients with heart failure. Intervention. Electronic monitoring of adherence to diuretic therapy (percentage of diuretic prescription container openings) and to scheduling (percentage of container openings within a specific time). Measurements and Main Results. All patients were prescribed a diuretic, most commonly furosemide (88%). Patients varied widely in adherence to therapy (p = 72% ± 30%) and to scheduling (p = 43% ± 30%). Education was a predictor of drug-taking adherence (p=0.0062) but not of scheduling adherence. Log-linear models revealed that poor scheduling adherence was associated with increased cardiovascular-related hospitalizations (X2 11.63, p=0.0006) and predicted more heart failure-related hospitalizations (X2 4.04, p=0.0444). In contrast, neither measure was significantly associated with cardiovascular- or heart failure-related emergency department visits. We found a moderate correlation between scheduling adherence and taking adherence (r = 0.6513). Conclusion. Patients taking a greater proportion of diuretic agents on schedule may decrease the risk of cardiovascular- and heart failure-related hospitalizations. If these findings are confirmed by a larger study, interventions to improve adherence and patient health outcomes should consider the timing of doses as well as the number of daily doses of a diuretic.

Original languageEnglish
Pages (from-to)326-332
Number of pages7
JournalPharmacotherapy
Volume23
Issue number3
DOIs
StatePublished - Mar 1 2003

Fingerprint

Patient Acceptance of Health Care
Diuretics
Heart Failure
Hospitalization
Therapeutics
Furosemide
Patient Compliance
Observational Studies
Prescriptions
Hospital Emergency Service
Linear Models
Appointments and Schedules
Prospective Studies
Education
Health
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Association between adherence to diuretic therapy and health care utilization in patients with heart failure. / Chui, Michelle A.; Deer, Melissa; Pressler, Susan; Tu, Wanzhu; Oury, Stacey; Brater, Craig; Murray, Michael.

In: Pharmacotherapy, Vol. 23, No. 3, 01.03.2003, p. 326-332.

Research output: Contribution to journalArticle

@article{2b35ee40e16b4f96b7ba67e791c89c87,
title = "Association between adherence to diuretic therapy and health care utilization in patients with heart failure",
abstract = "Study Objective. To determine the relationship between adherence to diuretic therapy and health care utilization. Design. Prospective, observational study. Setting. University-affiliated medical center. Patients. Forty-two patients with heart failure. Intervention. Electronic monitoring of adherence to diuretic therapy (percentage of diuretic prescription container openings) and to scheduling (percentage of container openings within a specific time). Measurements and Main Results. All patients were prescribed a diuretic, most commonly furosemide (88{\%}). Patients varied widely in adherence to therapy (p = 72{\%} ± 30{\%}) and to scheduling (p = 43{\%} ± 30{\%}). Education was a predictor of drug-taking adherence (p=0.0062) but not of scheduling adherence. Log-linear models revealed that poor scheduling adherence was associated with increased cardiovascular-related hospitalizations (X2 11.63, p=0.0006) and predicted more heart failure-related hospitalizations (X2 4.04, p=0.0444). In contrast, neither measure was significantly associated with cardiovascular- or heart failure-related emergency department visits. We found a moderate correlation between scheduling adherence and taking adherence (r = 0.6513). Conclusion. Patients taking a greater proportion of diuretic agents on schedule may decrease the risk of cardiovascular- and heart failure-related hospitalizations. If these findings are confirmed by a larger study, interventions to improve adherence and patient health outcomes should consider the timing of doses as well as the number of daily doses of a diuretic.",
author = "Chui, {Michelle A.} and Melissa Deer and Susan Pressler and Wanzhu Tu and Stacey Oury and Craig Brater and Michael Murray",
year = "2003",
month = "3",
day = "1",
doi = "10.1592/phco.23.3.326.32112",
language = "English",
volume = "23",
pages = "326--332",
journal = "Pharmacotherapy",
issn = "0277-0008",
publisher = "Pharmacotherapy Publications Inc.",
number = "3",

}

TY - JOUR

T1 - Association between adherence to diuretic therapy and health care utilization in patients with heart failure

AU - Chui, Michelle A.

AU - Deer, Melissa

AU - Pressler, Susan

AU - Tu, Wanzhu

AU - Oury, Stacey

AU - Brater, Craig

AU - Murray, Michael

PY - 2003/3/1

Y1 - 2003/3/1

N2 - Study Objective. To determine the relationship between adherence to diuretic therapy and health care utilization. Design. Prospective, observational study. Setting. University-affiliated medical center. Patients. Forty-two patients with heart failure. Intervention. Electronic monitoring of adherence to diuretic therapy (percentage of diuretic prescription container openings) and to scheduling (percentage of container openings within a specific time). Measurements and Main Results. All patients were prescribed a diuretic, most commonly furosemide (88%). Patients varied widely in adherence to therapy (p = 72% ± 30%) and to scheduling (p = 43% ± 30%). Education was a predictor of drug-taking adherence (p=0.0062) but not of scheduling adherence. Log-linear models revealed that poor scheduling adherence was associated with increased cardiovascular-related hospitalizations (X2 11.63, p=0.0006) and predicted more heart failure-related hospitalizations (X2 4.04, p=0.0444). In contrast, neither measure was significantly associated with cardiovascular- or heart failure-related emergency department visits. We found a moderate correlation between scheduling adherence and taking adherence (r = 0.6513). Conclusion. Patients taking a greater proportion of diuretic agents on schedule may decrease the risk of cardiovascular- and heart failure-related hospitalizations. If these findings are confirmed by a larger study, interventions to improve adherence and patient health outcomes should consider the timing of doses as well as the number of daily doses of a diuretic.

AB - Study Objective. To determine the relationship between adherence to diuretic therapy and health care utilization. Design. Prospective, observational study. Setting. University-affiliated medical center. Patients. Forty-two patients with heart failure. Intervention. Electronic monitoring of adherence to diuretic therapy (percentage of diuretic prescription container openings) and to scheduling (percentage of container openings within a specific time). Measurements and Main Results. All patients were prescribed a diuretic, most commonly furosemide (88%). Patients varied widely in adherence to therapy (p = 72% ± 30%) and to scheduling (p = 43% ± 30%). Education was a predictor of drug-taking adherence (p=0.0062) but not of scheduling adherence. Log-linear models revealed that poor scheduling adherence was associated with increased cardiovascular-related hospitalizations (X2 11.63, p=0.0006) and predicted more heart failure-related hospitalizations (X2 4.04, p=0.0444). In contrast, neither measure was significantly associated with cardiovascular- or heart failure-related emergency department visits. We found a moderate correlation between scheduling adherence and taking adherence (r = 0.6513). Conclusion. Patients taking a greater proportion of diuretic agents on schedule may decrease the risk of cardiovascular- and heart failure-related hospitalizations. If these findings are confirmed by a larger study, interventions to improve adherence and patient health outcomes should consider the timing of doses as well as the number of daily doses of a diuretic.

UR - http://www.scopus.com/inward/record.url?scp=0037372762&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037372762&partnerID=8YFLogxK

U2 - 10.1592/phco.23.3.326.32112

DO - 10.1592/phco.23.3.326.32112

M3 - Article

C2 - 12627931

AN - SCOPUS:0037372762

VL - 23

SP - 326

EP - 332

JO - Pharmacotherapy

JF - Pharmacotherapy

SN - 0277-0008

IS - 3

ER -