Abstract:
Background: Heart failure is a global health burden with increasing prevalence and new
incidences. It is a chronic cardiovascular disease that requires long-term treatment with appropriate
medications. Hence, prescribing appropriate medications and the patient’s adherence to
medications are essential in achieving optimum treatment outcomes among heart failure patients.
Objectives: To assess the medication appropriateness, medication adherence and evaluate the
influence of socio-demographic factors on medication adherence of heart failure patients
Methods: This was a cross-sectional observational study conducted at the cardiovascular clinic of
National Hospital Kandy. Patients diagnosed with heart failure, older than 18 years were recruited
after obtaining informed written consent. Appropriateness of clinic medications was assessed
using the Medication Appropriateness Index (MAI); higher MAI scores indicated low
appropriateness. A detailed medication history was obtained from each participant for the
medication adherence assessment using the Brief Medication Questionnaire (BMQ). Patients were
classified into four adherence-related categories based on their scores for each screen in BMQ.
Associations between medication adherence and socio-demographic factors were evaluated.
Results: The total number of study participants was 325. The mean±SD MAI score was 0.56±0.25
(median:0.55, IQR:0.71-0.40). The mean±SD total BMQ score was 1.16±0.10 (median:1.00,
IQR:1.70-0.43). Most of the patients were probable poor adherents (52.0%) followed by probable
adherents (20.9%), poor adherents (15.4%) and the least complete adherents (11.7%). Statistically
significant associations were observed between total BMQ score and age (p=0.039), gender
(p=0.003) and education level (p=0.027).
Conclusions: Appropriateness of prescribed medicines in the clinic was acceptable. However,
medication adherence among heart failure patients was considerably poor whereas age, gender,
and education level had influenced medication adherence. The importance of interventional studies
to improve medication adherence in heart failure patients is apparent.
