Factors associated with low adherence to medications in heart failure

Abstract

Background: Medical therapy is fundamental in the management of heart failure (HF), and it is associated with favorable outcomes. These outcomes are attainable with good adherence to medications. However, the level of adherence to HF medications and the associated factors have not been well documented in Nigeria. Aim: The aim of the study is to determine the level of adherence to HF medications and the associated factors in HF patients. Materials and Methods: This was a cross-sectional study of HF patients in a tertiary health facility. A researcher-administered questionnaire was used to obtain demographic variables, assess adherence to HF medications with the Morisky medication adherence (MA) scale, and determine barriers to adherence. The proportions of respondents with a high and low adherence were derived, and the associated factors were investigated with Chi-square tests and multiple logistic regression. Results: They were 168 respondents with a median age of 63 years, and 94 (56%) were females. The median MA score was 4.13. Forty eight (28.6%) and 120 (71.4%) had high and low MA, respectively. The associations of comorbidities, method of payment, and alternative medicines with the level of adherence gave p values of 0.000, 0.002, and 0.000, respectively. Barriers to adherence were financial 43 (35.8%), forgetfulness 38 (31.7), and others constituted 44 (36.7%). Conclusions: Adherence to HF medications is suboptimal. It is associated with out-of-pocket payment, comorbidities, and usage of alternative medicines. Financial constraint and forgetfulness are the common self-reported barriers to adherence. Interventions to address these factors should be initiated.