OBJECTIVE
To investigate adherence to treatment and factors related with it in patients with chronic heart failure (CHF) within outpatient register.
MATERIAL AND METHODS
COMPLIANCE study selected patients with verified CHF from PROFILE outpatient register. The number of patients equal 72 with CHF diagnosis, established during selection, was included. Previously, 40 patients were managed in specialized cardiology unit of research center and 32 patients visited for the first time. The general adherence to pharmacological treatment was determined using Adherence Scale of NSEP, and the adherence to medicines with evidence-based impact on disease prognosis in this patients’ cohort was investigated during the inclusion visit and after a year. The adherence was evaluated in scores, where 0 scores — absolute adherence, 1—2 scores — partial, incomplete adherence, 3 scores — partial non-adherence and 4 scores — absolute non-adherence. Patients who had 0 scores by questionnaire were considered to be compliant, and those who had 1 score or more — non-compliant.
RESULTS
The proportion of patients equal 47% was absolutely compliant to the previously prescribed pharmacological therapy, 43% — partial compliant and partial non-compliant, 10% — absolutely non-complaint when including in the study. Among the main non-adherence factors to pharmacological therapy, 38% of patients reported a high number of prescribed drugs, 27% of patients forgot to take the prescribed drugs, and 22% of patients noted the fear of side effects as the reason of non-adherence to therapy. The change of non-adherence factors was recorded after a year of observation. Forgetfulness took the main place (40%), the second most frequent factor was a high number of drugs (27%), and fear of side effects were noted only by 13% of patients, that significantly less than during the inclusion visit. The main factors of non-adherence to angiotensin-converting enzyme inhibitors/angiotensin receptor blocker administration was forgetfulness at the time of inclusion and a year later. The number of patients who do not want to take many drugs decreased from 5 to 1 (21 and 5%, respectively). The common factors of non-adherence to beta-blocking agents’ administration were forgetfulness (33% of patients) and reluctance to take many drugs (25%). The forgetfulness factor remained leading, and the number of patients who do not want to take drugs with proven efficacy in CHF significantly decreased (from 15% to 5%) after a year of observation.
CONCLUSIONS
The non-adherence factors to pharmacological therapy in patients with chronic heart failure are various and require further study and correction. The study within register allows to identify more specific factors for actual clinical practice. This investigation shows factors of non-adherence to particular drugs in patients with chronic heart failure for the first time.
