Medication Adherence and Its Associated Factors Among Outpatients with Heart Failure

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.