Examining the Relationship between Illness Perception, Adherence to Medication Regimen and Readmission in Patients with Heart Failure

Abstract

Abstract: Background: In spite of the advancement in heart-failure treatment, readmission of patients with this illness still imposes a heavy burden on the health system by increased treatment and care costs. However, half of the hospitalizations in these patients are preventable. Purpose: The purpose of this study was to examine the relationship between illness perception (IP), medication adherence (MA), and readmission during 30 days after discharge in chronic heart-failure patients. Methodology: The study was descriptive-correlational where 360 patients - with heart failure hospitalized in Shahid Madani Hospital in Tabriz - were selected using convenient sampling method. The tools used in the study were demographic questionnaire, Brief Illness Perception Questionnaire (BIPQ), Medication Adherence Report Scale (MARS), and readmission study 30 days after discharge by telephone and receiving a “yes” or “no” answer. Data was analyzed in SPSS13. Data analysis was done using independent t-test, Mann Whitney, ANOVA, Kruskal Wallis, Pearson correlation coefficient and Spearman-Brown correlation coefficient. Significance level was P less than 0.05. Results: The mean and standard deviation (SD) of IP and MA were 45.45 (9.33) and 23.91 (2.68), respectively. Overall, the results showed a significant direct correlation between IP and MA (r=0.196, P<0.001). There was a significant direct correlation between some aspects of IP - including illness control, treatment control, and concern over illness and IP with MA. There was, however, a significant negative relationship between the emotional manifestations of the illness such as anger, fear, discomfort, and depression with MA (r=-0.17 and P=0.001). There was no significant relationship between IP (p=0.199) and MA (p=0.602) with readmission 30 days after discharge (P> 0.05). Conclusion: Nurses can use the results of this study to identify patients at high risk of non-adherence to medication regimens and readmission. Suggestion for future studies include conducting similar studies in multiple places with a larger sample size and using objective tools to examine MA in patients with heart failure and qualitative studies of the factors affecting IP, MA, and readmission.