Kudos to Hanzhang Xu, medical instructor, for submitting the NIH R03 application entitled "An Innovative Approach for Understanding Trajectories of Medication Adherence in Patients with Heart Failure.” This proposal requests funds for a 2-year period with a proposed start date of July 1, 2020.

Heart failure (HF) is among the most common and costly chronic illnesses in older adults in the United States. Medication adherence is a critical component of long-term self-management in HF and is associated with improved symptom management, physical functioning, and the recurrence of complications. Despite the well-established evidence that medication adherence improves outcomes in HF, only half of patients with HF achieve adequate medication adherence. Although clinical guidelines emphasize the long-term benefits of medication adherence for HF outcomes, we lack critical knowledge of actionable time point(s) to effectively promote medication adherence during the course of illness. To address this gap in knowledge, we propose to carry out a series of analyses that use a novel method—group-based trajectory models—and leverage the strengths of two national datasets: (a) Medicare claims data, and (b) the Health and Retirement Study (HRS). The aims of this grant are to classify the medication adherence trajectories of the guideline recommended classes of medications while simultaneously examining the longitudinal patterns of adherence across the classes of medications, then overlay the World Health Organization model of adherence to better understand how patient characteristics are associated with trajectory typologies of medication adherence. If funded, this project will provide important scientific foundation for a future large-scale proposal to develop tailored strategies to improve adherence according to identified, predictable time points in the illness trajectory.