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      Medication Adherence and Health Literacy in Patients with Heart Failure: A Cross-Sectional Survey in Iran

      research-article
      Author(s): , PharmD, , PharmD, , PhD, , FESC, , PhD
      Publication date (Electronic, pub):
      Journal: HLRP: Health Literacy Research and Practice
      Publisher: SLACK Incorporated

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          Abstract

          Background:

          Heart failure is a costly condition with high morbidity and mortality rates in low- and middle-income countries. Nonadherence to prescribed therapies can lead to severe problems such as poorer health outcomes, higher health care expenditures, increased hospitalizations, and even higher mortality rates in patients with advanced heart disease.

          Objective:

          The aim of the present study is to investigate medication adherence and the association between medication adherence and health literacy in Iranian patients with heart failure.

          Methods:

          This study was conducted in the heart failure outpatient clinic of Shahid Rajaee Cardiovascular, Medical, and Research Center in Tehran, Iran. Medical records and validated questionnaires were used to collect the necessary information on the survey variables, including sociodemographic characteristics, medication adherence, and health literacy, for a total of 250 patients with heart failure. Stepwise logistic regression analysis was performed to identify the variables that independently and significantly predicted medication nonadherence.

          Key Results:

          The results showed that most patients with heart failure had low medication adherence. Some factors, including gender, health literacy, and duration of illness, were associated with adherence. The study results showed a positive association between higher health literacy and better medication adherence.

          Conclusion:

          In view of the results, further studies on heart failure are needed to investigate other factors related to medication adherence and health literacy level to achieve better disease management and improve patients' treatment adherence. [ HLRP: Health Literacy Research and Practice. 2022;6(3):e191–e199. ]

          Plain Language Summary:

          This study investigated the relationship between medication adherence and health literacy in Iranian patients with heart failure. The results showed that most patients had inadequate health literacy. Moreover, it showed a significant and positive relationship between health literacy and medication adherence.

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          Most cited references65

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          Global Public Health Burden of Heart Failure.

          Gianluigi Savarese, Lars Lund (2017)
          Heart failure (HF) is a global pandemic affecting at least 26 million people worldwide and is increasing in prevalence. HF health expenditures are considerable and will increase dramatically with an ageing population. Despite the significant advances in therapies and prevention, mortality and morbidity are still high and quality of life poor. The prevalence, incidence, mortality and morbidity rates reported show geographic variations, depending on the different aetiologies and clinical characteristics observed among patients with HF. In this review we focus on the global epidemiology of HF, providing data about prevalence, incidence, mortality and morbidity worldwide.
          Article 0 comments Cited 720 times – based on 0 reviews     Review now
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            Epidemiology and aetiology of heart failure.

            Boback Ziaeian, Gregg C. Fonarow (2016)
            Heart failure (HF) is a rapidly growing public health issue with an estimated prevalence of >37.7 million individuals globally. HF is a shared chronic phase of cardiac functional impairment secondary to many aetiologies, and patients with HF experience numerous symptoms that affect their quality of life, including dyspnoea, fatigue, poor exercise tolerance, and fluid retention. Although the underlying causes of HF vary according to sex, age, ethnicity, comorbidities, and environment, the majority of cases remain preventable. HF is associated with increased morbidity and mortality, and confers a substantial burden to the health-care system. HF is a leading cause of hospitalization among adults and the elderly. In the USA, the total medical costs for patients with HF are expected to rise from US$20.9 billion in 2012 to $53.1 billion by 2030. Improvements in the medical management of risk factors and HF have stabilized the incidence of this disease in many countries. In this Review, we provide an overview of the latest epidemiological data on HF, and propose future directions for reducing the ever-increasing HF burden.
            Article 0 comments Cited 478 times – based on 0 reviews     Review now
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              Factors affecting therapeutic compliance: A review from the patient’s perspective

              Jing Jin, Grant Sklar, Vernon Min Sen Oh … (2008)
              Objective To explore and evaluate the most common factors causing therapeutic non-compliance. Methods A qualitative review was undertaken by a literature search of the Medline database from 1970 to 2005 to identify studies evaluating the factors contributing to therapeutic non-compliance. Results A total of 102 articles was retrieved and used in the review from the 2095 articles identified by the literature review process. From the literature review, it would appear that the definition of therapeutic compliance is adequately resolved. The preliminary evaluation revealed a number of factors that contributed to therapeutic non-compliance. These factors could be categorized to patient-centered factors, therapy-related factors, social and economic factors, healthcare system factors, and disease factors. For some of these factors, the impact on compliance was not unequivocal, but for other factors, the impact was inconsistent and contradictory. Conclusion There are numerous studies on therapeutic noncompliance over the years. The factors related to compliance may be better categorized as “soft” and “hard” factors as the approach in countering their effects may differ. The review also highlights that the interaction of the various factors has not been studied systematically. Future studies need to address this interaction issue, as this may be crucial to reducing the level of non-compliance in general, and to enhancing the possibility of achieving the desired healthcare outcomes.
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                Author and article information

                Contributors
                Gholamhossein Mehralian
                Journal
                Journal ID (nlm-ta): Health Lit Res Pract
                Journal ID (iso-abbrev): Health Lit Res Pract
                Journal ID (publisher-id): HLRP
                Title: HLRP: Health Literacy Research and Practice
                Publisher: SLACK Incorporated (Thorofare, NJ )
                ISSN (Print): 2475-6024
                ISSN (Electronic): 2474-8307
                Publication date (Print, pub): July 2022
                Publication date (Electronic, pub): 05 August 2022
                Volume: 6
                Issue: 3
                Pages: e191-e199
                Author notes

                Soheila Rezaei, PharmD, is a Researcher, Department of Pharmacoeconomic and Pharma Management, School of Pharmacy, Shahid Beheshti University of Medical Sciences. Fatemeh Vaezi, PharmD, is a Researcher, Department of Pharmacoeconomic and Pharma Management, School of Pharmacy, Shahid Beheshti University of Medical Sciences. Golnaz Afzal, PhD, is an Assistant Professor, Department of Clinical Pharmacy, School of Pharmacy, Shahid Sadoughi University of Medical Science. Nasim Naderi, FESC, is a Professor of Cardiology, Fellowship in Heart Failure and Transplantation, Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences. Gholamhossein Mehralian, PhD, is a Senior Lecturer, Nottingham Business School, Nottingham Trent University.

                Address correspondence to Gholamhossein Mehralian, PhD, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Hashemi Highway, Valiasr Avenue, P.O. Box 14155-6153, Tehran, Iran; email: gmehralian@ 123456gmail.com .

                Disclosure: The authors have no relevant financial relationships to disclose.

                Article
                Other ID: 10.3928_24748307-20220718-02
                DOI: 10.3928/24748307-20220718-02
                PMC ID: 9359808
                PubMed ID: 35943838
                SO-VID: f7bd2ae2-31b9-4645-9869-98889cad7c6b
                Copyright © © 2022 Rezaei, Vaezi, Afzal, et al.; licensee SLACK Incorporated.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International ( https://creativecommons.org/licenses/by/4.0). This license allows users to copy and distribute, to remix, transform, and build upon the article, for any purpose, even commercially, provided the author is attributed and is not represented as endorsing the use made of the work.

                History
                Date received : 06 September 2021
                Date accepted : 19 January 2022
                Categories
                Subject: Original Research

                Data availability:

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