SAN ANTONIO — Poor medication adherence is significantly more common in heart failure patients who have excessive daytime sleepiness, a study shows.
The implication of this finding is that interventions aimed at improving excessive daytime sleepiness may pay dividends in terms of better medication adherence. This would be particularly advantageous in a condition such as heart failure, in which patients take numerous drugs that are important in controlling the neuroendocrine response to the disease, Barbara Riegel, D.N.Sc., observed.
She presented a study involving a convenience sample of 278 adult outpatients with chronic stage C heart failure who participated in structured in-home interviews by trained research assistants who assessed medication adherence during the previous month.
Participants were also evaluated for excessive daytime sleepiness according to the Epworth Sleepiness Scale. Excessive daytime sleepiness (defined as an Epworth score of 6 or greater) was present in 56.5% of study patients.
Among the subset of heart failure patients with excessive daytime sleepiness who had undergone testing in a sleep laboratory, the majority was found to have sleep-disordered breathing, with an apnea-hypopnea index of at least 15 events per hour, reported Dr. Riegel, who is with the University of Pennsylvania School of Nursing in Philadelphia.
The most problematic medication adherence issue for the study participants was forgetting to take their medications on schedule.
In all, 56% of the heart failure patients with excessive daytime sleepiness reported often taking their medications more than 2 hours late, compared with 38% of the subjects who were not sleepy. In addition, 10% of the subjects with excessive daytime sleepiness reported that they skipped consecutive medication doses, compared with 3% of nonsleepy patients.
Disclosures: This study was funded by the National Heart, Lung, and Blood Institute. Dr. Riegel reported having no financial conflicts.