University of Alabama at Birmingham, Birmingham, Alabama.
GSK Research & Development, Collegeville, Pennsylvania.
Am J Cardiol. 2019 May 15;123(10):1667-1674. doi: 10.1016/j.amjcard.2019.02.024. Epub 2019 Feb 23.
Medication regimens in adults with heart failure (HF) are complex which can complicate patient adherence. Individuals with HF frequently use beta blockers (BBs) for multiple indications, including hypertension and HF, but BBs can have significant side effects that may affect their use. We examined medication-taking behaviors and perceptions in individuals with HF with a particular focus on BBs. A mailed survey on medication use was administered to US adults with HF enrolled in the REasons for Geographic And Racial Differences in Stroke study. Among 518 respondents, 357 (69%) reported taking a BB. Nearly half (42%) reported taking ≥10 medications per day. However, 45% indicated that they did not miss any days taking medications, and over 85% reported willingness to take additional medications to prevent further healthcare encounters. Participants' perceptions of BB symptoms varied, but 56% of those who reported experiencing symptoms did not discuss this with their healthcare providers. Adults who experienced HF hospitalization had higher odds of reporting taking BBs to treat HF (odds ratio 1.51, 95% confidence interval 1.19, 1.91). Adults with hypertension were also likely to report taking BBs to treat high blood pressure (odds ratio 2.42, 95% confidence interval 1.79, 3.26). In conclusion, despite extensive medication regimens, individuals with HF were willing to take additional medications for their disease. Participant recognition of BB use for treating HF and co-morbidities was high, yet many do not report side effects to healthcare providers. In conclusion, better understanding of patients' medication-taking behaviors and perceptions may facilitate optimization of HF treatments.
心力衰竭(HF)成人的药物治疗方案很复杂,这可能会使患者难以坚持治疗。HF 患者经常因多种适应症(包括高血压和 HF)而使用β受体阻滞剂(BB),但 BB 可能会产生严重的副作用,从而影响其使用。我们研究了 HF 患者的服药行为和认知,特别关注 BB。我们向参加 REasons for Geographic And Racial Differences in Stroke 研究的美国 HF 成年患者邮寄了一份关于药物使用的调查问卷。在 518 名应答者中,有 357 名(69%)报告正在服用 BB。近一半(42%)报告每天服用≥10 种药物。然而,45%的人表示他们没有错过任何服药日,超过 85%的人表示愿意服用额外的药物来防止再次就医。参与者对 BB 症状的认知存在差异,但 56%报告出现症状的人并未就此与医疗服务提供者进行讨论。经历过 HF 住院的成年人更有可能报告服用 BB 来治疗 HF(比值比 1.51,95%置信区间 1.19,1.91)。患有高血压的成年人也更有可能报告服用 BB 来治疗高血压(比值比 2.42,95%置信区间 1.79,3.26)。总之,尽管 HF 患者的药物治疗方案很复杂,但他们愿意为治疗疾病而服用额外的药物。患者对 BB 治疗 HF 和合并症的认知度很高,但许多人并未向医疗服务提供者报告副作用。总之,更好地了解患者的服药行为和认知可能有助于优化 HF 治疗。