MEDICATION ADHERENCE IN OUTPATIENTS WITH HEART FAILURE
DOI:
https://doi.org/10.11603/2411-1597.2025.3-4.15464Keywords:
heart failure, diary, patient education, adherence, continuous nursing careAbstract
Introduction. In the management of heart failure, adherence to prescribed pharmacological therapy and maintaining a high level of treatment compliance are key factors. The aim of this study was to assess the impact of the "Heart Failure Symptom Monitoring Diary" on treatment adherence among outpatients with heart failure.
Main part. The study included 55 patients from the "City Polyclinic No. 2" in Chernivtsi. In the cardiology office, they received individual counseling, education, and a diary for daily self-monitoring of heart failure symptoms in outpatient settings. It was found that educational interventions improved adherence to pharmacotherapy from 39.2 % to 71.2 %, and adherence to a healthy lifestyle from 31.5 % to 82 %. Forgetfulness, missed doses, self-discontinuation of medications, and neglect of medication records significantly decreased (by 67.3 %, 58.2 %, 45.5 %, and 67.2 %, respectively) (p = 0.0007). A high level of adherence (9.1 points) after the intervention was achieved in 71 % of patients, moderate adherence in 21.8 %, and low adherence in only 7.2 % (p = 0.020). The average adherence score increased to 8.1 compared to 4.4, indicating a significant improvement. The vast majority of patients (92.7 %, n = 51) demonstrated excellent adherence (≥8 points) after the educational intervention. Among elderly female patients, who predominated in the study group, adherence increased from moderate to high (8.2 points vs. 5.1). Self-monitoring indicators improved, in particular: the frequency of regular weight monitoring increased by 62%, fluid intake control (within the recommended volume of 1–1.5 L per day) improved by 40.2%, and adherence to dietary recommendations regarding sodium restriction increased by 46.2%.
Conclusions. Targeted education and the use of a monitoring diary are effective educational tools for patients with heart failure, promoting greater disease awareness and treatment adherence, improving self-monitoring, facilitating lifestyle changes in outpatient settings, and supporting the implementation of individualized treatment plans.
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