Predictions of Adherence to Treatment in Patients Referred to the Heart Failure Clinic of Shahid Rajaee Hospital in Tehran

The objective of this study was to identify the level of treatment adherence and also sought to explore several demographic, clinical, comorbidities, and self-care behavior factors that may affect adherence among patients with heart failure (HF).

This single-center cross-sectional, questionnaire-based study was conducted on 500 adult HF patients referred to the clinic of Rajaie Cardiovascular, Medical, and Research Center, in Tehran, Iran, from February to July 2022. The level of treatment adherence was assessment through Modanloo’s questionnaire. An unadjusted and adjusted binary logistic regression model was used to check the effect of different factors on the patients’ adherence level.

Among 474 responders, 51.7% had “good” adherence to treatment. According to the results, age >54 years (odds ratio [OR]: 0.967, 95% confidence interval [CI]: 0.946–0.988, P = 0.002), mitral valve regurgitation (OR: 0.597, 95% CI: 0.362–0.982, P = 0.042) and HF duration (OR: 0.486, 95% CI: 0.274–0.862, P = 0.014) were found as independent variables associated with “poor” treatment adherence. However, higher educational level (OR: 3.313, 95% CI: 2.632–4.067, P < 0.001), New York Heart Association class I (OR: 3.231, 95% CI: 1.587–4.661, P = 0.002), ejection fraction (EF) >40% (OR: 1.023, 95% CI: 1.005–1.041, P = 0.013), HF with preserved EF (OR: 2.728, 95% CI: 1.387–5.365, P = 0.004), familiar with social media (OR: 3.792, 95% CI: 1.777–4.268, P < 0.001) and high awareness of HF (OR: 2.385, 95% CI: 1.072–3.044, P = 0.006) were significant positive predictors for good adherence to treatment.

Adherence to the treatment regimen has improved compared to previous studies, but is still suboptimal, particularly with respect to awareness of HF. Therefore, improving the awareness of patients as well as encouraging and supporting them for self-care behaviors can have a positive effect on treatment adherence.