Why the study?
Medication adherence in chronic heart failure is suboptimal, and few studies have integrated patients' perceptions of effective strategies for medication-taking and self-care in South Asian patients.
Observational (n=15)
No
Intrinsic and extrinsic facilitators play a key role in self-care and medication adherence among South Asian patients with chronic heart failure, highlighting the need for culturally tailored interventions.
Clinicians should integrate patient perceptions into CHF adherence plans; reinforces consensus on patient-centered strategies beyond GDMT alone.
Background : Adherence to a complex, yet effective medication regimen improves clinical outcomes in patients with chronic heart failure (CHF). However, patient adherence to an agreed upon plan for medication-taking is sub-optimal and continues to hover at 50% in developed countries. Studies to improve medication-taking have focused on interventions to improve adherence to guideline-directed medication therapy, yet few of these studies have integrated patients’ perceptions of what constitutes effective strategies for improved medication-taking and self-care in everyday life. The purpose of this formative study was to explore patient perceived facilitators of selfcare and medication-taking in South Asian CHF patients. Methods : We conducted in-depth interviews of patients with long standing heart failure admitted to the cardiology and internal medicine wards of a South Indian tertiary care hospital. We purposively sampled using the following criteria: sex, socio-economic status, health literacy and patient reported medication adherence in the month prior to hospitalization. We employed inductive coding to identify facilitators. At the end of 15 interviews (eight patients and seven caregivers; seven patient-caregiver dyads), we arrived at theoretical saturation for facilitators. Results : Facilitators could be classified into intrinsic (patient traits – situational awareness, self-efficacy, gratitude, resilience, spiritual invocation and support seeking behavior) and extrinsic (shaped by the environment – financial security and caregiver support, company of children, ease of healthcare access, trust in provider/hospital, supportive environment and recognizing the importance of knowledge). Conclusions: We identified and classified a set of key patient and caregiver reported self-care facilitators among Indian CHF patients. The learnings from this study will be incorporated into an intervention package to improve patient engagement, overall self-care and patient-caregiver-provider dynamics.
No takes yet. Share an insight, caveat, or question.
Kamath et al. (2020) conducted an observational in Chronic heart failure (n=15). Self-care facilitators was evaluated on Identified intrinsic and extrinsic facilitators of self-care. Intrinsic traits such as situational awareness and resilience, along with extrinsic factors like family support and healthcare access, were identified as key facilitators of self-care in chronic heart failure.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: