Medication Nonadherence and Associated Factors among Heart Failure Patients at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

Mohammed Assen Seid, Husien Nurahmed Toleha, Faisel Dula Sema
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Abstract

Background: Medication nonadherence, being one of the best predictors of hospitalization, increases the mortality rate and hospital readmission and reduces the quality of life of heart failure (HF) patients. Therefore, this study is aimed at assessing medication nonadherence and associated factors among HF patients at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

Methods: A cross-sectional study was conducted among 245 adult patients with HF from June to August 2017. The data were collected by using the medication Adherence Report Scale (MARS-5) and then entered and analyzed using SPSS® (IBM Corporation) version 24. Summary statistics were presented using frequency, proportion, and mean. Binary logistic regression analysis was done for identifying factors associated with medication nonadherence with a 95% confidence level and p value of less than 0.05.

Results: Among 245 patients with HF, about a quarter (23.7%) of them were medication nonadherent. More than one-third (37%) of HF patients had a history of at least one HF medication discontinuation. Refilling problems (48%) and getting better from the illness (27%) were the most commonly reported reasons for nonadherence. Presence of comorbidity (AOR = 2.761; 95%CI = 1.364, 5.589), taking three or more types of medication (AOR = 2.805; 95%CI = 1.404, 5.60), and being unmarried (AOR = 2.638, 95%CI = 1.279, 5.443) was significantly associated with medication nonadherence.

Conclusion: The self-reported medication nonadherence among HF patients was considerably high. Refilling problems and getting better from the illness were the most commonly reported reasons for nonadherence. The presence of comorbid illness, taking three or more types of medication, and being unmarried was significantly associated factors of medication nonadherence. Awareness creation among patients on the importance of medication adherence and targeted efforts to assess and mitigate reasons for medication nonadherence may be helpful.

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埃塞俄比亚西北部贡达尔大学综合专科医院心力衰竭患者的药物依从性及相关因素
背景:药物不依从是心衰患者住院的最佳预测因素之一,它增加了心衰患者的死亡率和再入院率,降低了心衰患者的生活质量。因此,本研究旨在评估埃塞俄比亚西北部贡达尔大学综合专科医院HF患者的药物依从性及其相关因素。方法:2017年6月至8月对245例成年HF患者进行横断面研究。采用药物依从性报告量表(MARS-5)收集数据,然后使用SPSS®(IBM Corporation)第24版进行录入和分析。汇总统计采用频率、比例和平均值。采用二元logistic回归分析确定与药物不依从相关的因素,置信水平为95%,p值小于0.05。结果:245例HF患者中,约1 / 4(23.7%)的患者药物不依从。超过三分之一(37%)的HF患者有至少一种HF药物停药史。补充问题(48%)和从疾病中恢复(27%)是最常见的不遵守报告的原因。存在合并症(AOR = 2.761;95%CI = 1.364, 5.589),服用三种及以上药物(AOR = 2.805;95%CI = 1.404, 5.60)、未婚(AOR = 2.638, 95%CI = 1.279, 5.443)与用药不依从显著相关。结论:心衰患者自我报告的药物依从性较高。补充问题和从疾病中恢复是最常见的不遵守报告的原因。存在合并症、服用三种或三种以上药物以及未婚是药物依从性不遵医嘱的显著相关因素。提高患者对药物依从性重要性的认识,有针对性地评估和减轻药物不依从性的原因可能会有所帮助。
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