Medication nonadherence in Nigerian heart failure patients: A cross sectional study

Abstract

Background: Anti-failure therapy is vital to the reduction of morbidity and mortality associated with heart failure (HF). Medication nonadherence (MNA) has been identified as a major limiting factor for the attainment of therapeutic goals. This study aimed to determine the prevalence and characteristics of MNA in HF patients attending Lagos University Teaching Hospital (LUTH), Lagos. Methods: This was a descriptive cross-sectional study involving 202 previously diagnosed HF patients attending an outpatient clinic in LUTH. Data were obtained from patient's medical records and the use of an interviewer-administered questionnaire. Medication Adherence Report Scale 5-items was used to determine MNA. Results: Of the 202 HF subjects, 68% (n = 128) were aged 31–60 years, 65% (n = 132) were females, 58%, (n = 116) were taking ≤4 pills/day, 54.5% were taking pills twice daily, and 72.3% (n = 146) had comorbid conditions. The overall prevalence of MNA was 69.3% with ACE inhibitors having the highest MNA of 73.2% and angiotensin receptor blocker/neprilysin inhibitor having the least MNA of 0%. MNA was independent of age, gender, educational status, pill burden, duration of HF, history of HF admission, functional status, and specific comorbidities (P < 0.05). However, the presence of three comorbidities was associated with lower MNA (P < 0.05). Conclusion: There is a high prevalence of MNA in Nigerian HF patients. Measures aimed at improving adherence are imperative to improve outcomes in these patients.