Doctoral Dissertations

Date of Award


Degree Type


Degree Name

Doctor of Philosophy



Major Professor

Sandra J. Mixer

Committee Members

Lisa C. Lindley, Joel G. Anderson, Elizabeth Dobbins


The prevalence of hepatitis C virus infection and cardiovascular disease in the United States is on the rise and affects millions of people. CVD is more predominant among individuals with HCV infection and is reduced when HCV is treated and sustained virologic response is achieved. A gap in the literature exists regarding HCV infection and medication adherence among adults with cardiac issues. The purpose of this study was to: (1) to examine the characteristics of individuals infected with HCV experiencing cardiac issues and (2) to evaluate the relationship between HCV infection and medication adherence among those with cardiac issues. Guided by an adapted version of the Self-Regulation Model for Control of Chronic Disease, this retrospective, observational, longitudinal study used combined data from the National Health and Nutrition Examination Survey years 2011–2016. The weighted sample included 9,918,628 adults with cardiac issues. Descriptive statistics were obtained and a multivariate logistic regression model was used to estimate the relationship between HCV status and medication adherence, while controlling for intrapersonal and external factors. The findings revealed younger age, Hispanic ethnicity, and substance use had a positive impact on cardiac medication adherence. Participants with depressive symptoms, arthritis, health insurance, and access to care were less likely to adhere to cardiac medications. Multiple factors may impact medication adherence among adults with cardiac issues. Implications for future research, policy, and practice were identified and discussed.


Portions of this document were previously published in journal "Gastroenterology Nursing."

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