Cardiology and Healthcare

Background & Aim: Poor adherence to medications is a common problem among Heart Failure (HF) patients. Inadequate adherence leads to increased HF exacerbations, reduced physical function and higher risk for hospital admission and death. Many interventions have been tested to improve adherence to HF medications, but the overall impact of such interventions on readmissions and mortality is unknown. We conducted a study to explore patients’ understanding and adherence to Heart Failure (HF) medications at a general hospital setting.

 

Method: We prospectively studied 196 patients (outpatients plus inpatients) of HF at our hospital. The information was gathered by oral interview as well as using questionnaire. There is currently no Heart Failure nurse working in our hospital.

 

Result: There were 110 male and 86 female patients with average age of 54 years. Most patients (78%) in NYHA class II and III. 15% of patients stopped or reduced the dose of diuretics on their own as they thought they didn’t need them anymore or they were thought to interfere in their life style. 36% patients believed that ACE inhibitors or ARBs were for blood pressure and therefore they had either stopped or were intending to stop. 43% patients were not keen on taking beta-blocker because of fear of various side effects and 12% of them already stopped the beta-blocker on their own. 56% of patients did not like the idea of increasing the dose of ACE Inhibitor, ARBs or beta-blocker to the maximum. Patients were ignorant of the role of different HF medications Aldosterone antagonists (86%), ACE Inhibitor or ARBs (76%), Beta blocker (70%). None of the patients who were on Ivabradine knew the role of the drug in HF but at the same time were not informed of any known side effects.

 

Conclusion: Heart Failure (HF) medications are evidence based with stringent research and scientific back up. They have proven benefit in terms of reducing morbidity and mortality significantly. However, compliance amongst patients to adhere to prescribed medications is poor. This is largely because of their lack of knowledge and poor understanding about themedications. It is therefore worth spending time and resources in educating patients with the help of multi-disciplinary heart failure team to achieve better outcome.