Medication adherence and survival among hospitalized heart failure patients in a tertiary hospital in Tanzania: a prospective cohort study.

Autor: Pallangyo P; Unit of Research, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania. pedro.pallangyo@gmail.com.; Department of Adult Cardiology, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania. pedro.pallangyo@gmail.com., Millinga J; Department of Nursing, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania., Bhalia S; Department of Adult Cardiology, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania., Mkojera Z; Unit of Research, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania., Misidai N; Unit of Research, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania., Swai HJ; Unit of Research, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania., Hemed NR; Unit of Research, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania., Kaijage A; Department of Adult Cardiology, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania., Janabi M; Department of Adult Cardiology, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania.
Jazyk: angličtina
Zdroj: BMC research notes [BMC Res Notes] 2020 Feb 21; Vol. 13 (1), pp. 89. Date of Electronic Publication: 2020 Feb 21.
DOI: 10.1186/s13104-020-04959-w
Abstrakt: Objective: Management of heart failure is complex and multifaceted but adherence to medications remains the cornerstone of preventing avoidable readmissions, premature deaths, and unnecessary healthcare expenses. Despite of evidence-based efficacy on anti-failure drugs, poor adherence is pervasive and remains a significant barrier to improving clinical outcomes in heart failure population.
Results: We enrolled 459 patients with diagnosis of heart failure admitted at a tertiary cardiovascular hospital in Dar es Salaam, Tanzania. The mean age was 46.4 years, there was a female predominance (56.5%), 67.5% resided in urban areas and 74.2% had primary education. Of the 419 participants eligible for assessment of medication adherence, 313 (74.7%) had poor adherence and 106 (25.3%) had good adherence. Possession of a health insurance was found to be the strongest associated factor for adherence (adjusted OR 8.7, 95% CI 4.7-16.0, p < 0.001). Participants with poor adherence displayed a 70% increased risk for rehospitalization compared to their counterparts with good adherence (adjusted RR 1.7, 95% CI 1.2-2.9, p = 0.04). Poor adherence was found to be the strongest predictor of early mortality (HR 2.5, 95% CI 1.3-4.6, p < 0.01). In conclusion, Poor medication adherence in patients with heart failure is associated with increased readmissions and mortality.
Databáze: MEDLINE
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