Evidence map›Paper›PMID 22054720›Full record

ArticleHeart & lung : the journal of critical care

Medication adherence mediates the relationship between marital status and cardiac event-free survival in patients with heart failure.

Jia-Rong Wu, Terry A Lennie, Misook L Chung, Susan K Frazier, Rebecca L Dekker, Martha J Biddle, Debra K Moser

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Heart & lung : the journal of critical care. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
70citing papers in PubMed, 1 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

70 citing papers in PubMed, 1 synthesis or guideline pooled it.

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  10. Marital Failure and Subsequent Heart Failure: A Prospective Study.Journal of the American Heart Association · 2025
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10 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

7 authors.

Jia-Rong WuUniversity of North Carolina at Chapel Hill, School of Nursing, Chapel Hill, North Carolina 27599-7460, USA. jiarongw@email.unc.edu
Terry A Lennie
Misook L Chung
Susan K Frazier
Rebecca L Dekker
Martha J Biddle
Debra K Moser

Funding

XENOBIOTIC TRANSFER INTO MILK NITROFURANTOINM01RR002602 · NCRR · UNIVERSITY OF KENTUCKY · PI WERMELING, DANIEL PAUL · 1985 to 2007
$12.1M
Biobehavioral Intervention in Heart FailureR01NR008567 · NINR · UNIVERSITY OF KENTUCKY · PI MOSER, DEBRA KAY · 2004 to 2008
$1.5M
Self-Management Pilot/Feasibility and Biobehavioral Outcomes CoreP20NR010679 · NINR · UNIVERSITY OF KENTUCKY · PI HALL, LYNNE ANDERSON · 2007 to 2011
$1.2M
Cognitive Therapy for Depressive Symptoms in Hospitalized Patients with Heart FaiK23NR013480 · NINR · UNIVERSITY OF KENTUCKY · PI DEKKER, REBECCA · 2012 to 2014
$356k
NCRR NIH HHS M01 RR002602NCRR NIH HHS M01RR02602NINR NIH HHS 1P20NR010679NINR NIH HHS K23 NR013480NINR NIH HHS P20 NR010679NINR NIH HHS R01 NR008567
6 · The paper itself

Abstract

objectivePrognosis is worse in unmarried patients compared with married patients with heart failure (HF). The reasons for differences in outcomes are unclear, but variations in medication adherence may play a role, because medication adherence is essential to achieving better outcomes. The study objective was to determine whether medication adherence mediated the relationship between marital status and cardiac event-free survival in patients with HF.

methodsDemographic, clinical, and psychosocial data were collected by questionnaires and medical record review for 136 patients with HF (aged 61 ± 11 years, 70% were male, 60% were in New York Heart Association class III/IV). Medication adherence was monitored objectively for 3 months using the Medication Event Monitoring System. Cardiac event-free survival data were obtained by patient/family interview, hospital database, and death certificate review. A series of regression and Cox survival analyses were performed to determine whether medication adherence mediated the relationship between marital status and event-free survival.

resultsCardiac event-free survival was worse in unmarried patients than in married patients. Unmarried patients were more likely to be nonadherent and 2 times more likely to experience an event than married patients (P = .017). Marital status was not a significant predictor of event-free survival after entering medication adherence in the model, demonstrating a mediation effect of adherence on the relationship of marital status to survival.

conclusionMedication adherence mediated the relationship between marital status and event-free survival. It is important to design interventions to increase medication adherence that take into account subgroups, such as unmarried patients, who are at higher risk for nonadherence.

Indexed as

Marital StatusCardiovascular AgentsDisease-Free SurvivalFemaleFollow-Up StudiesHeart FailureHumansMaleMedication AdherenceMiddle AgedPrognosisProspective StudiesPsychometricsSurveys and QuestionnairesCardiovascular Agents

Identifiers

PMID22054720
PMCPMC3288268

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Registered trials

None linked

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.