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阿姆哈拉地区西北部慢性心力衰竭患者的药物治疗不依从性及其预测因素

Medication non-adherence and its predictors among chronic heart failure patients in Northwest Amhara region.

作者信息

Tarekegn Getachew Yitayew, Dagnew Fisseha Nigussie, Moges Tilaye Arega, Asmare Zufan Alamire, Tsega Sintayehu Simie, Damtie Dejen Gedamu, Anberbr Sisay Sitotaw, Semman Mubarik Fetu, Bitew Bayih Endalew

机构信息

Department of Clinical Pharmacy, Pharmacy Education and Clinical Services Directorate, College of Health Sciences, Debre Tabor University, PO Box 272, Debre Tabor, Ethiopia.

Department of Ophthalmology, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia.

出版信息

Sci Rep. 2025 Jun 6;15(1):19968. doi: 10.1038/s41598-025-03748-4.

Abstract

Heart failure represents a substantial public health challenge, affecting over 64 million individuals worldwide. Effective adherence is essential to enhance patient quality of life and mitigate the risks of hospitalization associated with these progressive conditions. This study aims to assess the magnitude of non-adherence and identify associated factors among Chronic Heart Failure patients receiving follow-up care. A multicenter prospective cross-sectional institutional-based study involving 360 adult CHF patients was conducted from December 2023 to April 2024. Data were systematically collected utilizing a pretested abstraction format. Non-adherence rates were quantized, and multivariate logistic regression analysis was performed to identify significant predictors of non-adherence, with effect size measured by odds ratio. The study identified a non-adherence rate of 17.7% among the cohort. Key factors associated with increased non-adherence include irregular follow-up visits (AOR 1.11, CI 1.06-1.16), presence of orthopnea (AOR 5.02, CI 1.04-12.21), and cor pulmonale (AOR 12.00, CI 1.14-15.30). These findings suggest that experiencing orthopnea and those with irregular follow-ups are markedly more likely to have poor adherence to prescribed therapies. Improving medication adherence through regular follow-up and symptom management is crucial for better outcomes and reducing healthcare burdens in CHF patients.

摘要

心力衰竭是一项重大的公共卫生挑战,全球有超过6400万人受其影响。有效的依从性对于提高患者生活质量和降低与这些进展性疾病相关的住院风险至关重要。本研究旨在评估慢性心力衰竭患者接受随访护理时不依从的程度,并确定相关因素。2023年12月至2024年4月进行了一项多中心前瞻性横断面机构研究,纳入360例成年慢性心力衰竭患者。数据采用预先测试的摘要格式进行系统收集。对不依从率进行量化,并进行多因素逻辑回归分析以确定不依从的显著预测因素,效应大小用比值比衡量。该研究在队列中确定了17.7%的不依从率。与不依从增加相关的关键因素包括随访不规律(调整后比值比1.11,可信区间1.06 - 1.16)、端坐呼吸(调整后比值比5.02,可信区间1.04 - 12.21)和肺心病(调整后比值比12.00,可信区间1.14 - 15.30)。这些发现表明出现端坐呼吸和随访不规律的患者明显更有可能对规定治疗的依从性差。通过定期随访和症状管理提高药物依从性对于改善慢性心力衰竭患者的结局和减轻医疗负担至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92cc/12144149/8e60976a45bb/41598_2025_3748_Fig1_HTML.jpg

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