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Title AN EVALUATION OF RECURRENT HEART FAILURE PATIENTS' ADHERENCE TO MEDICATIONS IN CHANGI GENERAL HOSPITAL |
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Type Young Investigator Award |
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Theme ACC Asia & SCS 32nd Annual Scientific Meeting |
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Topic Heart Failure / Cardiovascular Rehabilitation & Preventive Cardiology |
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Main Author Daniel Fletcher1 |
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Presenting Author Daniel Fletcher1 |
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Co-Author Chun Yan Ong1 Sherry Goh1 Weng Leong Woo1 Michael Macdonald2 |
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Department / Institution / Country Pharmacy / Changi General Hospital / Singapore1 Cardiology / Changi General Hospital / Singapore2 |
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Objective(s) Poor adherence to medications often leads to aggravation of heart failure (HF) symptoms, leading to re-hospitalisations. Hence, there is a need to understand the rate of and reasons for non-adherence. This study was thus undertaken to (1) assess patients’ adherence to prescribed HF medications and knowledge of HF and (2) examine the factors underlying non-adherence. |
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Material and Method This is a cross-sectional study conducted at Changi General Hospital. HF patients who were readmitted from November 2015 to March 2016 were recruited for this study. Eligible patients who agreed to be enrolled in this study were asked a series of questions. This includes a (1) dichotomous questions on comprehension of instructions on medication use, (2) open-ended questions on adherence to medications, (3) eight-item Morisky Medication Adherence Scale (MMAS-8) and (4) Dutch HF Knowledge Scale (DHFKS) was administered. Results were tabulated and analyzed using the Statistical Package for Social Sciences (SPSS) v.21.0 Fisher’s exact test for statistical significance. |
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Result(s) Fifty patients were recruited whereby 80% could understand the instructions on medication use, especially when aided by caregivers. However, 67% of the patients had inadequate HF knowledge, by scoring 9 or less on the DHFKS. Questions on HF general knowledge gathered the lowest score of 32%. Patients with at least secondary school education scored better for DHFKS than their counterparts, with an average score of 9.2 versus 6.9 out of 15 (p=0.04). Nevertheless, their adherence as indicated by MMAS-8 scores were not significantly better (p=0.25). Apart from poor knowledge on medication use (61%), forgetfulness (26%) and low health literacy rates (9%) are among the top few reasons considered by patients as barriers for adherence. |
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Conclusion These findings provide interesting insights into the rates of and reasons for non-adherence, which in turn may assist healthcare professionals in devising strategies to address frequent re-hospitalizations due to poor medication adherence. |