Relation of sociodemographic, clinical, and quality-of-life variables to adherence in the cardiac arrhythmia suppression trial.

Clearly, age and education are important factors for predicting adherence in CAST, given that they appear in all three regressions. Moreover, the 4-month and 1-year results indicate that mental health and presence of a spouse are important predictors. Physical function, stress, angina, and history of MI may also provide additional information regarding adherence levels. It is interesting to note that although adherence was higher for patients who have "good" social characteristics, such as having a spouse, support, integration, perceived good health, good mental health, low stress, and education, it was also better for those patients who had "poor" physical characteristics such as a history of angina, a history of MI, and low physical function. In the multivariate analysis, older age was also associated with good adherence. These observations are not necessarily intuitive and support the need for further research in this area. If patients at risk for poor adherence can be identified prospectively, strategies may be developed to improve their subsequent medical care in such a way to favorably affect and improve their outcomes.