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Graduation Term

Spring 2026

Degree Name

Doctor of Philosophy (PhD)

Department

Mennonite College of Nursing

Committee Chair

Marilyn Prasun

Committee Member

John R. Blakeman

Committee Member

Sandra Nielsen

Committee Member

Thomas P. McCoy

Abstract

Background: Guideline-directed medications are recommended to reduce morbidity and mortality in patients with heart failure (HF). Medication adherence is crucial to achieve optimal outcomes in these patients. The purpose of this study was to examine the prevalence of medication adherence and associated factors among patients admitted to the hospital diagnosed with HF. Methods: A retrospective chart review of randomly selected patients admitted with a diagnosis of HF from three midwestern hospitals between January 1, 2024, to December 31, 2024, was completed. Medication adherence was assessed through the documented patients’ self-report during medication reconciliation and provider admission notes of the prescribed guideline-directed HF medications. Analysis involved descriptive and multivariable logistic regression to examine factors associated with medication adherence. Results: The sample (N = 210) was 52.9% (n = 111) male, 78.1% (n = 164) Caucasian, 41% (n = 86) married with a mean age of 71.5 years (SD = 14.3). Patient-reported adherence to prescribed medications on admission varied: ACE/ARB/ARNi 35.3%, Beta blocker 52.3%, Aldosterone Antagonist 48.8%, and SGLT2i 65.1%. Patients were least adherent to loop diuretics at 33.3%. The only significant factor identified was the total number of HF medications, where the odds of adherence decreased by 47.7% for each additional HF medication prescribed (AOR=.523, 95% CI=[.299, .914], p= .023). Conclusion: Medication adherence remains critically important in managing patients diagnosed with HF. Further research is warranted to examine approaches to identify patients who are nonadherent to their medications and address barriers.

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Dissertation-ISU Access Only

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