Gunnthorsdottir Ingibjorg, Almarsdottir Anna Birna, Andersen Karl, Gunnarsdottir Anna I, Svansdottir Erla, Einarsson Hafsteinn, Ingimarsdottir Inga Jona
Department of Cardiology, Landspitali - The National University Hospital of Iceland, Reykjavík, Iceland.
School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland.
Clin Pharmacol Ther. 2025 Apr;117(4):1088-1097. doi: 10.1002/cpt.3526. Epub 2024 Dec 18.
Adhering to medication regimens is key behavior to alleviate symptoms and slow disease progression in heart failure (HF). This study explores cardiac healthcare providers' perceptions and experiences of factors influencing medication adherence (MA) in HF patients, with findings contributing to developing a HF-specific MA assessment scale. Using a cross-sectional, mixed methods design, we conducted an online survey with both closed and open-ended questions distributed to cardiac healthcare providers, working at the National University Hospital in Iceland. The survey consisted of 103 questions divided into 18 themes. Analysis included descriptive statistics of the participants' responses to closed responses with simplified scoring. Free-text responses were grouped into thematic categories and then into subthemes. Of 104 healthcare providers invited, 73 (70%) participated. Key factors identified as most beneficial for supporting MA included supportive patient-provider relationships (97%), selecting suitable drug formulation (96%), healthcare support at home (95%), and multi-dose dispensing from pharmacies (93%). The youngest and oldest HF patients were believed to be at the highest risk of medication non-adherence, particularly among males. Other patients estimated at increased risk included those with alcohol and/or substance abuse (89%), those with limited knowledge of medication effects (89%), those perceiving medication as useless (88%), and those with cognitive impairment (86%). Most participants (73%) agreed that healthcare providers should assess and document MA in clinical care. These findings provide a comprehensive overview of factors that cardiac healthcare providers believe influence non-adherence in HF patients, contributing to the development of a HF-specific MA scale.
坚持药物治疗方案是缓解心力衰竭(HF)症状和减缓疾病进展的关键行为。本研究探讨了心脏科医疗服务提供者对影响HF患者药物治疗依从性(MA)因素的看法和经验,研究结果有助于制定针对HF的MA评估量表。采用横断面混合方法设计,我们对冰岛国立大学医院的心脏科医疗服务提供者进行了一项包含封闭式和开放式问题的在线调查。该调查由103个问题组成,分为18个主题。分析包括对参与者对封闭式问题的回答进行描述性统计并简化评分。自由文本回答被归类为主题类别,然后再细分为子主题。在邀请的104名医疗服务提供者中,73名(70%)参与了调查。被确定为对支持MA最有益的关键因素包括支持性的医患关系(97%)、选择合适的药物剂型(96%)、家庭医疗支持(95%)以及药房的多剂量配药(93%)。最年轻和最年长的HF患者被认为药物治疗不依从风险最高,尤其是男性。其他被估计风险增加的患者包括有酒精和/或药物滥用问题的患者(89%)、对药物作用了解有限的患者(89%)、认为药物无用的患者(88%)以及有认知障碍的患者(86%)。大多数参与者(73%)同意医疗服务提供者应在临床护理中评估并记录MA。这些发现全面概述了心脏科医疗服务提供者认为影响HF患者不依从的因素,有助于制定针对HF的MA量表。