Patient-Reported Compliance in older age patients with chronic heart failure

Abstract

The purpose of the study was to evaluate compliance with medical treatment in elderly patients with heart failure (HF), and to identify factors that associated with patients' compliance levels. Methods and results 475 patients (including 222 women), mean age 69.7±7.7, with HF, hospitalized at University Hospital between January and December 2018 were included in the study. The patients were selected by a physician specializing in cardiology. A cardiac nurse assessed the non-pharmacological level of compliance using the Revised Heart Failure Compliance Questionnaire (RHFCQ). The socio-clinical data were obtained from medical records. The majority of the study group were patients in NYHA II (62.4%) and NYHA III (28.3%), the mean duration of the disease was 6.2±4.9 years, and the mean ejection fraction of the left ventricle (EF) was 48.6±12.6. The average level of compliance in the study group measured on a scale from 0 to 4 points was: median = 2.7, IQR [2.32; 3.25]. Only 6.9% of the respondents adhere to recommendations totally (all dimensions of RHFCQ). In univariate analysis, predictors negatively affecting compliance were: female gender (rho =-0.325), age below 65 years (rho =-0.014)), loneliness (rho =-0.559), number of hospitalizations (rho =-0.242), higher stage of NYHA (rho =-1.612), co-morbidities (rho =-0.729), re-hospitalizations (rho =-0.729), beta-blockers treatment (rho =-1.612) and diuretics treatment (rho =-0.276). Factors positively affecting compliance were: EF�45% (rho = 0.020) and treatment with ACEI/ARB (rho = 0.34), whereas compliance was negatively affected by-EF<45% (β = 0.009). Independent predictors influencing the level of compliance were: loneliness (β =-1.816), number of hospitalizations (β =-0.117), NYHA III and IV and number of co-morbidities (β =-0.676).

Impact of Beliefs about Medicines on the Level of Intentional Non-Adherence to the Recommendations of Elderly Patients with Hypertension

“…Another predictor of lower intentional non-adherence levels in our study was being single, which is more commonly reported as a determinant of unintentional non-adherence, associated with a lack of motivation to follow treatment recommendations [ 39 ].…”

The roles of health literacy and social support in improving adherence to self‐care behaviours among older adults with heart failure

“…Effective self‐care, including symptom monitoring, regular exercise, sodium restriction and weight control, is a key component of HF management to improve the patient's prognosis (Herber et al, 2018; Jankowska‐Polanska et al., 2020). Recent studies have reported that self‐care behaviours can improve the health status and quality of life of patients with HF and reduce readmission and mortality rates (Beckie, Campbell, Schneider, & Macario, 2017; Lei & Cai, 2018; Toukhsati et al., 2019).…”

“…Recent studies have reported that self‐care behaviours can improve the health status and quality of life of patients with HF and reduce readmission and mortality rates (Beckie, Campbell, Schneider, & Macario, 2017; Lei & Cai, 2018; Toukhsati et al., 2019). Unfortunately, patients with HF feel that self‐care is difficult because of the multiple requirements of treatment regimens, such as polypharmacy and lifestyle adjustments for multimorbid conditions (Jankowska‐Polanska et al, 2020; Uchmanowicz, Jankowska‐Polańska, Mazur, & Froelicher, 2017). Older adults with HF are less likely to adhere to self‐care behaviours than younger patients are (Cocchieri et al., 2015).…”

“…Optimal self‐care behaviours are vital to reduce adverse health outcomes among older patients with HF (Herber, Atkn, Stork, & Wilm, 2018). However, adherence to self‐care behaviours is reported to be poor in older people with HF (Jankowska‐Polanska et al., 2020); for that reason, underlying predictors need to be identified.…”

Sex Differences in the Association between Atrial Fibrillation and 90-Day Adverse Outcomes among Older Adults with Heart Failure: A Retrospective Cohort Study

“…Heart failure (HF) is a significant global health issue and disproportionately influences older individuals [ 1 , 2 , 3 ]. Older patients are liable to developing HF because of age-related physiologic and pathologic changes [ 4 ].…”