Research Abstracts

The Journal of Informed Pharmacotherapy 2004;15:411.

Health Beliefs as Predictors of Non-adherence with Heart Failure Medications

Phuong Hoang, Stephen Shalansky, Pharm.D., FCSHP, Andrew Ignaszewski, MD, Wolfgang Linden, Ph.D., Adrian Levy, Ph.D, Biljana Radulovic

Pharmacy Department, Heart Function Clinic and the Centre for Health Evaluation Outcome Sciences, St. Paul’s Hospital; Psychology Department, University of British Columbia, Vancouver, BC, Canada

Canadian Society of Hospital Pharmacists (British Columbia Branch) Residency Research Presentation Night, Vancouver, British Columbia, Canada. May 2003.


To identify health beliefs associated with non-adherence with congestive heart failure (CHF) medications, in patients attending St. Paul’s Heart Function and Pre-Transplant Clinic.


A major Canadian adult acute care teaching hospital.


Patients taking one or more CHF medication were surveyed using three previously validated health belief scales: the health beliefs model (HBM), the multidimensional health locus of control scale, and the beliefs about medicines questionnaire. CHF medication adherence was calculated over 14 months using the British Columbia prescription claims database. Univariate and multivariate analyses were used to identify independent predictors of non-adherence (<80%, based on refill patterns).


Nine (10%) of 88 patients included in the final analyses were non-adherent. The multivariate analysis found two independent predictors of non-adherence: the number of CHF medications (odds ratio 0.38 per additional medication; 95% CI 0.20-0.73; P=0.004) and the perceived barriers score, a component of the HBM (odds ratio 1.56 per score increment; 95% CI 1.04-2.34; P=0.033), respectively. Although 78% of non-adherent patients had a perceived barriers score between 8 and 11, a substantial number of adherent patients were found across all perceived barrier scores. 


While the perceived barrier score was shown to be a statistically significant predictor of non-adherence, it does not effectively discriminate between non-adherent and adherent patients. 

Copyright © 2004 by the Journal of Informed Pharmacotherapy. All rights reserved.