Background/Objectives 

This study examined whether beliefs about medicines, drug attitudes, and depression independently predicted anticoagulant and antiarrhythmic adherence (focusing on the implementation phase of nonadherence) in patients with atrial fibrillation (AF).

Methods 

This cross-sectional study was part of a larger longitudinal study. Patients with AF (N = 118) completed the Patient Health Questionnaire-8. The Beliefs about Medicines Questionnaire, Drug Attitude Inventory, and Morisky-Green-Levine Medication Adherence Scale (self-report adherence measure), related to anticoagulants and antiarrhythmics, were also completed. Correlation and multiple logistic regression analyses were conducted.

Results 

There were no significant differences in nonadherence to anticoagulants or antiarrhythmics. Greater concerns (r = 0.23, P = .01) were significantly, positively associated with anticoagulant nonadherence only. Depression and drug attitudes were not significantly associated with anticoagulant/antiarrhythmic adherence. Predictors reliably distinguished adherers and nonadherers to anticoagulant medication in the regression model, explaining 14% of the variance, but only concern beliefs (odds ratio, 1.20) made a significant independent contribution to prediction (χ² = 11.40, P = .02, with df = 4). When entered independently into a regression model, concerns (odds ratio, 1.24) significantly explained 10.3% of the variance (χ² = 7.97, P = .01, with df = 1). Regressions were not significant for antiarrhythmic medication (P = .30).

Conclusions 

Specifying medication type is important when examining nonadherence in chronic conditions. Concerns about anticoagulants, rather than depression, were significantly associated with nonadherence to anticoagulants but not antiarrhythmics. Anticoagulant concerns should be targeted at AF clinics, with an aim to reduce nonadherence and potentially modifiable adverse outcomes such as stroke.

中文翻译：

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检查房颤患者对药物的依从性：药物信念、态度和抑郁的作用。

背景/目标 

本研究检验了对药物、药物态度和抑郁症的信念是否独立预测了房颤(AF)患者的抗凝剂和抗心律失常依从性（重点是不依从性的实施阶段）。

方法 

这项横断面研究是一项更大的纵向研究的一部分。房颤患者（N = 118）完成了患者健康问卷 8。还完成了与抗凝剂和抗心律失常药相关的药物信念问卷、药物态度量表和 Morisky-Green-Levine药物依从性量表（自我报告依从性测量）。进行了相关性和多元逻辑回归分析。

结果 

抗凝剂或抗心律失常药的不依从性没有显着差异。更大的担忧（r = 0.23，P = .01）仅与抗凝剂不依从性显着正相关。抑郁症和药物态度与抗凝剂/抗心律失常药物依从性没有显着相关性。预测可靠区分遵从者和nonadherers在回归模型抗凝药物，解释方差的14％，但仅关注的信念（比值比1.20）作出预测的显著独立贡献（χ ² = 11.40，P = 0.02，同df= 4）。当独立进入回归模型时，关注点（优势比，1.24）显着解释了 10.3% 的方差（χ ² = 7.97，P = .01，df = 1）。抗心律失常药物的回归不显着（P = .30）。

结论 

在检查慢性病患者的依从性时，指定药物类型很重要。对抗凝剂而非抑郁症的担忧与不依从抗凝剂而非抗心律失常药显着相关。抗凝问题应针对 AF 诊所，目的是减少不依从性和潜在可改变的不良后果，如中风。