Date of Completion

9-2-2014

Embargo Period

9-2-2014

Keywords

Heart Failure, Medications, Self-Efficacy, Mixed-Methods

Major Advisor

Patricia J. Neafsey

Associate Advisor

Richard H. Fortinsky

Associate Advisor

Colleen Delaney

Field of Study

Nursing

Degree

Doctor of Philosophy

Open Access

Open Access

Abstract

Although prescription medication adherence has been studied in the Heart Failure (HF) population, little attention has focused on the patient’s overall medication practices including over the counter medications and their confidence in following their prescribed therapeutic regime. The primary aim of this study is twofold: 1) Measure and gain a more complete understanding of HF medication management self-efficacy and 2). Quantify self-medication practices. Patients with HF live with the certainty that their quality of life depends on the proper management of multiple medications and innumerable therapeutic regimes. Failure to properly manage prescription medications increases the risk of exacerbation of HF and increased rates of rehospitalization. The prevention agenda for the United States, Healthy People 2020, calls for identification of the most significant, preventable threats to US health and establishes national goals to reduce these threats. This project identifies adverse medication practices in patients with HF, a significant threat to the health of the nation's older adults. Older adults have significant knowledge deficits with respect to interactions of prescription and over the counter (OTC) medicines. This mixed-method study employed a convergent parallel mixed-methods design (Creswell & Plano Clark, 2011). A telephone interview was used to complete the ActualMeds™ and HF medication self-efficacy instrument. Concurrently, qualitative interviews are conducted on the patients who scored high and low on HF medication self-efficacy to discover their perspective of their therapeutic regime. The qualitative interviews inform the researcher and validate the data from the quantitative strand providing greater depth to the process of patients’ self-medication practices and adherence along with self-efficacy when living with HF. Data reveal that polypharmacy is pervasive and patients are prescribed medications not recommended for the geronotologic population and / or risk anticholinergic burden. Future study is required to enhance this technology to provide seamless communication between providers and patients to decrease the risk to patients.

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