Testing a novel pictorial medication sheet to improve adherence in veterans with heart failure and cognitive impairment

• Cognitive impairment (CI) is prevalent and associated with worsened medication adherence
• Poor medication adherence is a key factor in hospital readmissions for heart failure (HF)
• We tested a pictorial medication sheet to improve adherence in veterans with CI and HF
• Use of medication images improved adherence with complex regimens
• Intervention was well received, easily implemented and not resource-intensive

Objectives(a) To evaluate efficacy of a pictorial medication sheet to improve adherence in veterans with heart failure (HF) and cognitive impairment (CI); (b) to describe acceptance of the intervention.BackgroundCI is prevalent in HF and is associated with worsened medication adherence. The Veteran's Administration has developed a medication image library; however, use of images to improve adherence has not been tested.MethodsThirty-six veterans with HF and CI were enrolled and provided pictorial medication sheets and an optional alarmed pillbox. Adherence pre-and post-intervention was determined by 30-day pill counts. Acceptance was assessed from interviews.ResultsTwenty-seven veterans (75%) completed the study. Overall medication adherence was poor, however there was significant improvement from pre-intervention (M = 79.74, SD = ±16.98) to post-intervention (M = 84.74, SD = ±10.00) adherence (t(26) = 2.16, p < .05, Cohen's d = .42).ConclusionsThis pilot study provides preliminary evidence that medication images improve adherence with complex medication regimens. The intervention was well received by patients.