Influencing factors of medication adherence among older patients with chronic heart failure:an analysis based on COM-B model
XIE Chuantao
GU Yanhong
LI Yumei
SUN Na
JIANG Ruijie
Abstract：Objective:To investigate the status quo of medication adherence among older patients with chronic heart failure,and to analyze pathways of medication literacy,cognitive function,social support,and medication beliefs on medication adherence based on capacity,opportunity,motivation-behavior(COM-B)model.Methods:A total of 412 older patients with chronic heart failure admitted to the Department of Cardiology,Shanghai Fifth People's Hospital,Fudan University were conveniently selected as subjects from January to September 2022.General information questionnaire,Morisky Medication Adherence Scale(MMAS),Mini-Mental State Examination(MMSE),Social Support Rated Scale(SSRS),Medication Literacy Assessment in Spanish and English(MedLitRxSE)and The Beliefs about Medicines Questionnaire-Specific(BMQ-specific)were used for investigation.A structural equation modeling was adopted for path analysis.Results:The MMAS score of older patients with chronic heart failure was 5.75±1.75,189 patients(45.9%)had poor medication adherence.Medication literacy,cognitive function,social support,and medication beliefs had direct impact on medication adherence,and the effect were 0.278,0.099,0.127 and 0.531,respectively.Medication literacy also indirectly affected medication adherence through medication belief,with effect of 0.146.Cognitive function also indirectly affected medication adherence through medication literacy and medication beliefs,with effect of 0.167.Social support also indirectly affected medication adherence through medication literacy,with effect of 0.151.Conclusions:Older patients with chronic heart failure have low medication adherence level.Medication literacy,cognitive function,and social support all affect medication adherence through direct or indirect effects,and medication beliefs directly affect medication adherence.
Keywords：older adultschronic heart failuremedication adherencemedication literacycognitive functionsocial supportmedication beliefspath analysis
Publication Date：2024-01-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 246-251 )