Reasons for Non-compliance with medication and Disease severity among heart failure patients at Benazir Bhutto Hospital Rawalpindi

Disease Severity among Heart Failure Patients

Authors

  • Imran Saeed Ali Department of Cardiology, PAF Hospital, Islamabad, Pakistan
  • Rizwana Shahid Assistant Professor Community Medicine, Rawalpindi Medical University, Rawalpindi
  • Muhammad Asad Department of Cardiology, Benazir Bhutto Hospital, Rawalpindi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v3i05.231

Keywords:

Disease Severity among Heart Failure Patients

Abstract

Heart failure is a silent epidemic that is growing exponentially among both genders. Objectives: To determine the reasons for non-compliance with medication and severity of illness among heart failure patients. Methods: A cross-sectional descriptive study was done among 277 heart failure patients who visited Cardiology department of Benazir Bhutto Hospital during 2020 and enrolled in study through consecutive non-probability sampling. Data was gathered pertinent to demographics, hospital stay, comorbidities, drug compliance, physical activity and reasons for expiry. Severity of disease was categorized by using NYHA classification. Variations in mean age of the both genders and length of hospital stay between recovering and expiring patients were statistically determined by independent sample t-test. P-value ≤ 0.05 was taken significant. 95% CI were also computed. Results: Of the 277 patients, 56% and 44% were males and females respectively with mean age 56.5 ± 15.9 years. Most (65.7%) were illiterate. There was significant difference (P 0.003) (95%CI (1.85 – 9.35) in mean age of both genders. About 71.8% and 25.6% patients belonged to low and middle social class respectively and 68% of them were non-compliant with medication. 59.3% were non-compliant due to unawareness while 23.4% and 15.9% had non-compliance due to non-affordability and adversity of medicines respectively. Out of 15 expiring cases, 13 succumbed to cardiac arrest. Mean length of hospital stay was 5.92 ± 3.7 days. About 122 and 112 cases were in NYHA heart failure class III and IV respectively. Conclusion: Incognizance about the medication was the prime reasons for non-compliance

References

Khangura J and Goodlin SJ. Heart failure treatment in the elderly. Expert Review of Cardiovascular Therapy. 2011 Sep; 9(9):1171-9. doi: 10.1586/erc.11.128

Joseph SM, Cedars AM, Ewald GA, Geltman EM, Mann DL. Acute decompensated heart failure: contemporary medical management. Texas Heart Institute Journal. 2009; 36(6):510-20

Gheorghiade M, Adams KF, Cleland JG, Cotter G, Felker GM, Filippatos GS, et al. Phase III clinical trial end points in acute heart failure syndromes: a virtual roundtable with the Acute Heart Failure Syndromes International Working Group. American Heart Journal. 2009 Jun; 157(6):957-70. doi: 10.1016/j.ahj.2009.04.010

O'Connor CM, Stough WG, Gallup DS, Hasselblad V, Gheorghiade M. Demographics, clinical characteristics, and outcomes of patients hospitalized for decompensated heart failure: observations from the IMPACT-HF registry. Journal of Cardiac Failure. 2005 Apr; 11(3):200-5. doi: 10.1016/j.cardfail.2004.08.160

Ruppar TM, Cooper PS, Mehr DR, Delgado JM, Dunbar-Jacob JM. Medication Adherence Interventions Improve Heart Failure Mortality and Readmission Rates: Systematic Review and Meta-Analysis of Controlled Trials. Journal of the American Heart Association. 2016 Jun; 5(6):e002606. doi: 10.1161/JAHA.115.002606

Kumar A, Mohammadnezhad M, May W. Patients' Perception of Factors Influencing Noncompliance with Medication among Cardiac Patients in Fiji: A Qualitative Study. Patient Prefer Adherence. 2021 Aug; 15:1843-1852. doi: 10.2147/PPA.S322731

Osterberg L and Blaschke T. Adherence to medication. New England journal of medicine. 2005 Aug; 353(5):487-97. doi: 10.1056/NEJMra050100

Jimmy B and Jose J. Patient medication adherence: measures in daily practice. Oman Medical Journal. 2011 May; 26(3):155-9. doi: 10.5001/omj.2011.38

Brown MT and Bussell JK. Medication adherence: WHO cares? Mayo Clinic Proceedings. 2011 Apr; 86(4):304-14. doi: 10.4065/mcp.2010.0575

Akhtar Y, Rahman Afridi MA, Ali Z, Khan AM. Factors Affecting Adherence to Medications in Hypertensive Patients Visiting a Teaching Hospital in Khyber Pakhtunkhwa. JPMI: Journal of Postgraduate Medical Institute. 2022 Apr; 36(2). doi: 10.54079/jpmi.36.2.3060

Kajimoto K and Sato N. Sex Differences in New York Heart Association Functional Classification and Survival in Acute Heart Failure Patients With Preserved or Reduced Ejection Fraction. Canadian Journal of Cardiology. 2020 Jan; 36(1):30-36. doi: 10.1016/j.cjca.2019.08.020

Mosterd A and Hoes AW. Clinical epidemiology of heart failure. Heart. 2007 Sep; 93(9):1137-46. doi: 10.1136/hrt.2003.025270

Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics--2015 update: a report from the American Heart Association. Circulation. 2015 Jan; 131(4):e29-322. doi: 10.1161/CIR.0000000000000152

Wu JR and Moser DK. Medication Adherence Mediates the Relationship Between Heart Failure Symptoms and Cardiac Event-Free Survival in Patients With Heart Failure. Journal of Cardiovascular Nursing. 2018 Feb; 33(1):40-46. doi: 10.1097/JCN.0000000000000427

Ho KK, Pinsky JL, Kannel WB, Levy D. The epidemiology of heart failure: the Framingham Study. Journal of the American College of Cardiology. 1993 Oct; 22(4 Suppl A):6A-13A. doi: 10.1016/0735-1097(93)90455-a

Maas AH and Appelman YE. Gender differences in coronary heart disease. Netherlands Heart Journal. 2010 Dec; 18(12):598-602. doi: 10.1007/s12471-010-0841-y

Cesaroni G, Mureddu GF, Agabiti N, Mayer F, Stafoggia M, Forastiere F, et al. Sex differences in factors associated with heart failure and diastolic left ventricular dysfunction: a cross-sectional population-based study. BMC Public Health. 2021 Feb; 21(1):415. doi: 10.1186/s12889-021-10442-3

Cediel G, Codina P, Spitaleri G, Domingo M, Santiago-Vacas E, Lupón J, et al. Gender-Related Differences in Heart Failure Biomarkers. Frontiers in Cardiovascular Medicine. 2021 Jan; 7:617705. doi: 10.3389/fcvm.2020.617705

Wu JR and Moser DK. Medication Adherence Mediates the Relationship Between Heart Failure Symptoms and Cardiac Event-Free Survival in Patients With Heart Failure. Journal of Cardiovascular Nursing. 2018 Feb; 33(1):40-46. doi: 10.1097/JCN.0000000000000427

van der Wal MH, Jaarsma T, Moser DK, Veeger NJ, van Gilst WH, van Veldhuisen DJ. Compliance in heart failure patients: the importance of knowledge and beliefs. European Heart Journal. 2006 Feb; 27(4):434-40. doi: 10.1093/eurheartj/ehi603

Hauptman PJ. Medication adherence in heart failure. Heart Failure Reviews. 2008 Feb; 13(1):99-106. doi: 10.1007/s10741-007-9020-7

Lehane E and McCarthy G. Intentional and unintentional medication non-adherence: a comprehensive framework for clinical research and practice? A discussion paper. International Journal of Nursing Studies. 2007 Nov; 44(8):1468-77. doi: 10.1016/j.ijnurstu.2006.07.010

Tigabe Tekle M, Bekalu AF, Tefera YG. Length of hospital stay and associated factors among heart failure patients admitted to the University Hospital in Northwest Ethiopia. PLoS One. 2022 Jul; 17(7):e0270809. doi: 10.1371/journal.pone.0270809

Mitani H, Funakubo M, Sato N, Murayama H, Rached RA, Matsui N, et al. In-hospital resource utilization, worsening heart failure, and factors associated with length of hospital stay in patients with hospitalized heart failure: A Japanese database cohort study. Journal of Cardiology. 2020 Oct; 76(4):342-349. doi: 10.1016/j.jjcc.2020.05.010

Zaya M, Phan A, Schwarz ER. Predictors of re-hospitalization in patients with chronic heart failure. World Journal of Cardiology. 2012 Feb; 4(2):23-30. doi: 10.4330/wjc.v4.i2.23

Foraker RE, Rose KM, Chang PP, Suchindran CM, McNeill AM, Rosamond WD. Hospital length of stay for incident heart failure: Atherosclerosis Risk in Communities (ARIC) cohort: 1987-2005. The Journal of Healthcare Quality. 2014 Feb; 36(1):45-51. doi: 10.1111/j.1945-1474.2012.00211.x

Downloads

Published

2022-10-31
CITATION
DOI: 10.54393/pjhs.v3i05.231
Published: 2022-10-31

How to Cite

Saeed Ali, I. ., Shahid, R. ., & Asad, M. . (2022). Reasons for Non-compliance with medication and Disease severity among heart failure patients at Benazir Bhutto Hospital Rawalpindi: Disease Severity among Heart Failure Patients. Pakistan Journal of Health Sciences, 3(05), 184–188. https://doi.org/10.54393/pjhs.v3i05.231

Issue

Section

Original Article

Plaudit