Adherence to Self-Care Behaviours and Knowledge on Treatment among Heart Failure Patients in Ethiopia: The Case of a Tertiary Teaching Hospital

Abstract

Aim: Non adherence to self-care behaviour is common in patients with heart failure leading to reduced quality of life, increased morbidity, mortality and health care costs. We assessed adherence to self-care behaviours and knowledge among adult patients with heart failure on active follow up. Method and results: Hospital based cross-sectional study was employed and patient reported adherence to self-care behaviours and knowledge on heart failure was assessed among 328 adult heart failure patients. The mean (± standard deviation (SD)) age was 52 (± 17) years; 55.5% were men. Among 26 self-care behaviours studied, four of the top eight most frequently performed were related to taking prescribed medications, and the seven least frequently performed ones were concerned with symptom monitoring or management. Adherence to individual self-care behaviours ranged from 9.7% to 99.7% however, cumulative good adherence was low at 62.7%, and only 17.4% of patients reported good adherence with all 26 self-care recommendations, indicating high rates of selective adherence. The mean (± SD) total knowledge score was 7.38 ± 2.2 out of a maximum score of 14. Multivariate analysis showed that age, co-morbidity, NYHA functional class and heart failure knowledge score were independent predictors of poor adherence to self-care behaviours (P<0.01). Conclusion: Overall adherence to heart failure self-care behaviours is low and selective. Majority of patients had a sever knowledge deficit related to heart failure and self-care behaviours. Age, co-morbidity, NYHA class and heart failure knowledge score were independent predictors for poor over all adherences.