Evidence map›Paper›PMID 18381183›Full record

ArticleJournal of cardiac failure2008

Objectively measured, but not self-reported, medication adherence independently predicts event-free survival in patients with heart failure.

Jia-Rong Wu, Debra K Moser, Misook L Chung, Terry A Lennie

Abstract read
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In one paragraph

Article in Journal of cardiac failure, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 86 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
86citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

86 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  19. Investigating adherence to tyrosine kinase inhibitors in renal cancer.Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners · 2025
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26 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Jia-Rong WuUniversity of Kentucky, College of Nursing, Lexington, Kentucky 40536-0232, USA.jiarongwu@uky.edu
Debra K Moser
Misook L Chung
Terry A Lennie

Funding

XENOBIOTIC TRANSFER INTO MILK NITROFURANTOINM01RR002602 · NCRR · UNIVERSITY OF KENTUCKY · PI MOSER, DEBRA KAY · 1985 to 2007
$12.1M
Biobehavioral Intervention in Heart FailureR01NR008567 · NINR · UNIVERSITY OF KENTUCKY · PI MOSER, DEBRA KAY · 2004 to 2008
$1.5M
NCRR NIH HHS M01 RR002602NCRR NIH HHS M01RR02602NINR NIH HHS R01 NR008567
6 · The paper itself

Abstract

objectiveMedication nonadherence is presumed to be related to poor clinical outcomes, yet this relationship rarely has been tested using objective adherence measures in patients with heart failure. Which objective indicators of medication adherence predict clinical outcomes are unknown. The study objective was to determine which indicators of medication adherence are predictors of event-free survival.

methodsPatients (N = 134) with heart failure (69% were male, aged 61 +/- 11 years, 61% with New York Heart Association class III/IV heart disease) were enrolled in this 6-month longitudinal study. Adherence was measured using two measures: 1) an objective measure, the Medication Event Monitoring System (MEMS); and 2) self-reported adherence (Medical Outcomes Studies Specific Adherence Scale). Three indicators of adherence were assessed by MEMS: 1) dose-count, percentage of prescribed doses taken; 2) dose-days, percentage of days correct number of doses taken; and 3) dose-time, percentage of doses taken on schedule. Events (emergency department visits, rehospitalization, and mortality) were obtained by patient/family interview and hospital databases.

resultsIn Cox regression, two of the three MEMS indicators, dose-count and dose-day, predicted event-free survival before and after controlling for age, gender, ejection fraction, New York Heart Association class, angiotensin-converting enzyme inhibitor use, and beta-blocker use (P = .004, P = .008, and P = .224, respectively). Self-report adherence did not predict outcomes (P = .402).

conclusionDose-count and dose-day predicted event-free survival. Neither dose-time nor self-reported adherence predicted outcomes. Health care providers should assess specific behaviors related to medication taking rather than a global patient self-assessment of patient adherence.

Indexed as

AgedAge DistributionCardiovascular AgentsDisease-Free SurvivalDose-Response Relationship, DrugDrug Administration ScheduleFemaleHeart FailureHumansKaplan-Meier EstimateLongitudinal StudiesMaleMiddle AgedPatient CompliancePredictive Value of TestsProbabilityCardiovascular Agents

Identifiers

PMID18381183
PMCPMC2751635

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.