Assessment of adherence to treatment recommendations among patients with heart failure: a cross-sectional study

Heart failure (HF) is a chronic condition characterized by significant impairment of the cardiovascular system, leading to a decline in health-related quality of life, recurrent hospitalizations, and increased mortality risk. It poses a substantial challenge for modern medicine, particularly when patients fail to adhere to therapeutic recommendations. The primary aim of this study was to evaluate the level of adherence to therapeutic guidelines among patients with HF and identify factors influencing adherence levels.

The study comprised 105 HF patients admitted to the cardiology department. A diagnostic survey approach was utilized, employing the Adherence in Chronic Diseases Scale (ACDS) along with a self-developed questionnaire.

The findings revealed that 39.05% of participants exhibited a moderate level of adherence to therapeutic recommendations, while 34.29% reported high adherence and 26.67% displayed low adherence. Most of the patients (n = 66) had a rather good level of knowledge. Factors such as higher education (p < 0.001), engagement in mental work (p = 0.001), favorable socioeconomic status (p < 0.001), being in a stable relationship (p < 0.001), and residing with family (p < 0.001) were associated with increased adherence levels. The multivariable linear regression model indicated significant (p < 0.05) independent predictors that positively influenced the ACDS score, including being in a relationship, widowhood, and average or poor financial situation. Conversely, factors such as obesity and respiratory diseases were associated with a decrease in the ACDS score (p < 0.05).

This study underscores the moderate adherence level to therapeutic recommendations among HF patients. Sociodemographic factors including education level, relationship status, occupation, financial stability, and living arrangements significantly impact adherence. Conversely, patients with obesity, respiratory conditions, or frequent HF-related hospitalizations demonstrate lower adherence. Patient education emerges as a pivotal factor influencing adherence. Tailored interventions targeting these factors could enhance adherence and optimize HF management outcomes.