25% of heart failure patients had low medication adherence, which was linked to lower quality of life, especially in those with cardiac devices (p=0.037).
What is the level of medication adherence and its association with quality of life in adult outpatients with chronic heart failure?
A significant proportion of heart failure patients exhibit low medication adherence, which is associated with poorer quality of life and is more common in patients with intracardiac devices.
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Abstract Background Heart failure (HF) is a crucial cardiac complication which might lead to increased morbidity, frequent hospitalizations, and mortality. There are significant advancements in the treatment of HF. However, the overall prognosis remains poor. This could be due to various patients’ characteristics, such as the medication adherence and quality of life. Purpose In this study, we aimed to evaluate the adherence of the patients with heart failure to the guideline directed medication regimen and assessing the quality of life the patients. Methods This cross-sectional study, conducted from December 2023 to August 2024, targeted adult outpatients diagnosed with chronic heart failure. Eligibility criteria included being 18 years or older, having a confirmed diagnosis of chronic heart failure, and the capability to answer questionnaires. Data collection involved comprehensive questionnaires on demographic and clinical characteristics, the Morisky Medication Adherence Scale-8 (MMAS-8) for adherence assessment, and the EuroQol 5-Dimension 3-Level Questionnaire (EQ-5D-3L) for quality-of-life evaluation. Statistical analysis was performed using SPSS version 25, with the Kolmogorov-Smirnov test, chi-square test, Fisher’s exact test, ANOVA, Kruskal-Wallis-H test, and logistic regression analysis applied as appropriate. P-values 0.05 were considered statistically significant. Results Out of the 300 patients diagnosed with heart failure, 64.7% were male with a median age of 63 years. The majority had underlying conditions, including hypertension (35.7%), dyslipidemia (27.7%), and diabetes (25.7%). Most patients (69%) were diagnosed with heart failure with reduced ejection fraction (HFrEF), and more than half (62.4%) were classified as NYHA III and IV. Echocardiographic results revealed a median ejection fraction of 30%, and 56.3% had a history of myocardial infarction. Medication adherence assessment showed 25% of patients had low adherence, 44.6% had moderate adherence, and only 30.3% had high adherence. Quality of life (QoL) was linked to adherence levels; patients with higher adherence had better QoL. Significant differences in QoL were also noted among patients with varying NYHA classifications, with more severe symptoms associated with lower QoL (p0.001). Based on the logistic regression model older patients had lower risk of low adherence status (p=0.037) and patients with intracardiac devices had higher risk of low adherence status (p=0.037). No other parameter significantly associated with low adherence status. Conclusion Due to the importance of guideline directed medication therapy in patients with heart failure, we observed high rate of low adherence in this population. Furthermore, a Lower QoL was observed in patients with low adherence. We propose that patients with heart failure are at increased risk of low adherence to medication therapy specifically patients with cardiac devices.Graphical Abstract
Mahmoudi et al. (Sat,) reported a other. 25% of heart failure patients had low medication adherence, which was linked to lower quality of life, especially in those with cardiac devices (p=0.037).