Medication Adherence and Its Associated Factors Among Outpatients with Heart Failure

Anan S Jarab; Walid A Al-Qerem; Hanan Walid Hamam; Karem H Alzoubi; Shrouq R Abu Heshmeh; Tareq L Mukattash; Eman Alefishat

doi:10.2147/PPA.S410371

Medication Adherence and Its Associated Factors Among Outpatients with Heart Failure

Patient Prefer Adherence. 2023 May 8:17:1209-1220. doi: 10.2147/PPA.S410371. eCollection 2023.

Authors

Anan S Jarab^{1

2}, Walid A Al-Qerem³, Hanan Walid Hamam¹, Karem H Alzoubi^{4

5}, Shrouq R Abu Heshmeh¹, Tareq L Mukattash¹, Eman Alefishat^{6

7

8}

Affiliations

¹ Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan.
² College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates.
³ Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, 11733, Jordan.
⁴ Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates.
⁵ Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.
⁶ Department of Pharmacology, College of Medicine and Health Science, Khalifa University of Science and Technology, Abu Dhabi, 127788, United Arab Emirates.
⁷ Department Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, University of Jordan, Amman, 11942, Jordan.
⁸ Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, 127788, United Arab Emirates.

Abstract

Background: Poor adherence to heart failure (HF) medications represents a major barrier to achieve the desired health outcomes in those patients.

Objective: To assess medication adherence and to explore the factors associated with medication non-adherence among patient with HF in Jordan.

Methods: The current cross-sectional study was conducted at the outpatient cardiology clinics at two main hospitals in Jordan from August 2021 through April 2022. Variables including socio-demographics, biomedical variables, in addition to disease and medication characteristics were collected using medical records and custom-designed questionnaire. Medication adherence was assessed using the 4-item Morisky Medication Adherence Scale. Multinomial logistic regression analysis was performed to identify the factors that are significantly and independently associated with medication non-adherence.

Results: Of the 427 participating patients, 92.5% had low to moderate medication adherence. Results of the regression analysis revealed that that patients who had higher education level (OR=3.36; 95% CI 1.08-10.43; P=0.04) and were not suffering from medication-related side effects (OR=4.7; 95% CI 1.91-11.5; P=0.001) had significantly higher odds of being in the moderate adherence group. Patients who were taking statins (OR=16.59; 95% CI 1.79-153.98; P=0.01) or ACEIs/ ARBs (OR=3.95; 95% CI 1.01-15.41; P=0.04) had significantly higher odds of being in the high adherence group. Furthermore, Patients who were not taking anticoagulants had higher odds of being in the moderate (OR=2.77; 95% CI 1.2-6.46; P=0.02) and high (OR=4.11; 95% CI 1.27-13.36; P=0.02) adherence groups when compared to patients who were taking anticoagulants.

Conclusion: The poor medication adherence in the present study sheds the light on the importance of implementing intervention programs which focus on improving patients' perception about the prescribed medications particularly for patients who have low educational levels, receive an anticoagulant, and do not receive a statin or an ACEI/ ARB.

Keywords: Jordan; heart failure; intervention; medication adherence; medication concerns; medication necessity.

Grants and funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.