Medication Adherence and Associated Factors Among Chronic Heart Failure Patients on Follow Up in North Shewa Public Hospitals, Oromia Region, Ethiopia

Abstract

Background Chronic heart failure affects around 26 million people globally. World Health Organization data shows only about half of chronically ill patients in developed countries adhere to recommended medication, with even lower rates in developing countries. Medication adherence is critical for managing chronic heart failure affects symptoms, delaying disease progression, and preventing hospitalizations. However, poor adherence leads to increased re-hospitalizations, morbidity, mortality, and healthcare costs. Objective To assess medication adherence and its associated factors among chronic heart failure patients on follow-up at North Shewa public hospitals, Oromia Region, Ethiopia, in 2023. Methods An institutional-based cross-sectional study design was conducted from March 1 to April 30 2023 G.C. A total of 603 sample size were selected consecutively among those coming for chronic OPD after being proportionally allocated to five hospitals in the zone. Data were collected using an interviewer-administered questionnaire and a medical chart review. Data were entered into Epi-data version 3.1, then exported to SPSS version 26 for analysis. Variables with a P value < 0.25 in the bivariate analysis were included in the multivariate logistic regression model. The degree of association was expressed using an adjusted odds ratio (AOR) with a 95% confidence interval (CI) at a P value < 0.05 Result Among 603 patients, 56% had optimal medication adherence with 95% CI: (52.1, 60). Being able to read and write (AOR: 2.20; 95% CI: 1.34, 3.61), having a secondary education (AOR: 1.97; 95% CI: 1.06, 3.67), having community-based health insurance (AOR: 1.82; 95% CI: 1.22, 2.71), not having co-morbidity (AOR: 1.82; 95% CI: 1.18, 2.52), taking a number of drugs < 2 (AOR: 2.11; 95% CI: 1.20, 2.45), not adding salt when cooking (AOR: 1.72; 95% CI: 1.20, 2.45), and asking a doctor or nurse without fear (AOR: 1.87; 95% CI: 1.03, 3.40) were factors associated with medication adherence among CHF. Conclusion This study found 56% of chronic heart failure patients had optimal medication adherence. Factors associated with higher adherence included higher education, community health insurance, lack of comorbidities, fewer medications, avoiding added salt, and comfort communicating with providers. Health professionals should provide education to strengthen medication adherence.