Patient-Reported Compliance in older age patients with chronic heart failure

PLoS One. 2020 Apr 16;15(4):e0231076. doi: 10.1371/journal.pone.0231076. eCollection 2020.

Abstract

Methods and results: 475 patients (including 222 women), mean age 69.7±7.7, with HF, hospitalized at University Hospital between January and December 2018 were included in the study. The patients were selected by a physician specializing in cardiology. A cardiac nurse assessed the non-pharmacological level of compliance using the Revised Heart Failure Compliance Questionnaire (RHFCQ). The socio-clinical data were obtained from medical records. The majority of the study group were patients in NYHA II (62.4%) and NYHA III (28.3%), the mean duration of the disease was 6.2±4.9 years, and the mean ejection fraction of the left ventricle (EF) was 48.6±12.6. The average level of compliance in the study group measured on a scale from 0 to 4 points was: median = 2.7, IQR [2.32; 3.25]. Only 6.9% of the respondents adhere to recommendations totally (all dimensions of RHFCQ). In univariate analysis, predictors negatively affecting compliance were: female gender (rho = -0.325), age below 65 years (rho = -0.014)), loneliness (rho = -0.559), number of hospitalizations (rho = -0.242), higher stage of NYHA (rho = -1.612), co-morbidities (rho = -0.729), re-hospitalizations (rho = -0.729), beta-blockers treatment (rho = -1.612) and diuretics treatment (rho = -0.276). Factors positively affecting compliance were: EF≥45% (rho = 0.020) and treatment with ACEI/ARB (rho = 0.34), whereas compliance was negatively affected by-EF<45% (β = 0.009). Independent predictors influencing the level of compliance were: loneliness (β = -1.816), number of hospitalizations (β = -0.117), NYHA III and IV and number of co-morbidities (β = -0.676).

Conclusions: Patients with HF do not adhere to therapeutic recommendations. The lowest compliance levels were found for exercise and daily weighing, and the highest for follow-up appointment-keeping and medication. Loneliness and age are the strongest predictors which influence the level of compliance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Aged
  • Female
  • Heart Failure / epidemiology*
  • Heart Failure / physiopathology
  • Heart Failure / therapy*
  • Hospitalization
  • Humans
  • Male
  • Medical Records
  • Middle Aged
  • Patient Compliance*
  • Patient Reported Outcome Measures
  • Stroke Volume / physiology
  • Surveys and Questionnaires

Substances

  • Adrenergic beta-Antagonists

Grants and funding

This work was supported by Wroclaw Medical University [ST.A210.I6.040]. The publication was also prepared under the project of NŚ and BJP financed from the funds granted by the Ministry of Science and Higher Education in the “Regional Initiative of Excellence” programme for the years 2019–2022, project number 016/RID/2018/19. http://www.rid.umed.wroc.pl/ The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.