Key result
Poor medication adherence in patients with heart failure was associated with a 70% increased risk for rehospitalization (RR 1.7) and a significantly higher risk of early mortality.
Why the study?
Despite evidence-based efficacy of anti-failure drugs, poor adherence is pervasive and remains a barrier to improving clinical outcomes in heart failure.
Does good medication adherence reduce rehospitalization and mortality in hospitalized heart failure patients?
Cohort (n=459)
No
Does good medication adherence reduce rehospitalization and mortality in hospitalized heart failure patients?
Poor medication adherence in heart failure patients in a resource-limited setting is strongly associated with increased 6-month rehospitalization and mortality.
May warrant adherence support in heart failure care; leaves open whether interventions reduce rehospitalization or mortality.
Objective : Management of heart failure is complex and multifaceted but adherence to medications remains the cornerstone of preventing avoidable readmissions, premature deaths, and unnecessary healthcare expenses. Despite of evidence-based efficacy on anti-failure drugs, poor adherence is pervasive and remains a significant barrier to improving clinical outcomes in heart failure population. Results : We enrolled 459 patients with diagnosis of heart failure admitted at a tertiary cardiovascular hospital in Dar es Salaam, Tanzania. The mean age was 46.4 years, there was a female predominance (56.5%), 67.5% resided in urban areas and 74.2% had primary education. Of the 419 participants eligible for assessment of medication adherence, 313 (74.7%) had poor adherence and 106 (25.3%) had good adherence. Possession of a health insurance was found to be the strongest associated factor for adherence (AOR 8.7, 95% CI 4.7-16.0, P <0.001). Participants with poor adherence displayed a 70% increased risk for rehospitalization compared to their counterparts with good adherence (ARR 1.7, 95% CI 1.2-2.9, p = 0.04). Poor adherence was found to be the strongest predictor of early mortality (HR 2.5, 95% CI 1.3-4.6, p<0.01). In conclusion, Poor medication adherence in patients with heart failure is associated with increased readmissions and mortality.
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Pallangyo et al. (2020) conducted a cohort in Heart failure (n=459). Poor medication adherence vs. Good medication adherence was evaluated on Rehospitalization (RR 1.7, 95% CI 1.2-2.9, p=0.04). Poor medication adherence in patients with heart failure was associated with a 70% increased risk for rehospitalization (RR 1.7) and a significantly higher risk of early mortality.
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