Raimondas Kubilius, Ieva Česnavičiūtė, Laura Pereckaitė, Algirdas Rudys
Objective. To determine the problems of medication adherence, and their impact on the quality and fullness of life in patients with chronic systolic heart failure. Materials and methods. Our research was executed in the Clinic of Cardiology at Kaunas Clinics of Lithuanian University of Health Sciences. Chosen patients ill with chronic heart failure answered the anonymous survey which consisted of the following questionnaires: the eight-item Morisky Medication Adherence Scale (MMAS-8), the Minnesota Living with Heart Failure questionnaire (MLHFQ), the EQ-5D health questionnaire, and the visual scale of the fullness of life. The sociodemographic features and medical information of the patients were obtained and analyzed. The tasks of our work were these: to evaluate the medication habbits of the patients ill with chronic heart failure, to identify the obstacles to adhere to the medication regimen at home, and to estimate the impact of poor medication adherence on quality and fullness of life of the mentioned patients. Results. Total of 100 patients were surveyed, including 55 percent of women and 45 percent of men. The mean age of participants was 66,53 (SD ± 7,95 years). 80 percent of patients did not adhere to the medication properly. The main obstacles were forgetfulness (21,3%), long duration of medication administration (21,3%), and the lack of information (20,1%). Statistically, emotional health was worse among the patients who poorly adhered to the medication recomendations, compared to those whose adherence was mediocre and good. However, we did not find statistically significant difference of emotional health among the patients who adhered to their medication well and satisfactorily. The fullness of life is as higher as the medication adherence is better, but there is no significant difference between mediocre and poor adherence. Conclussions. Most patients do not adhere to their medication properly. Half of the patients cease to administer their medication when they start to feel better, and a quarter of patients quit their medication without consulting their doctor as their condition gets worse. The rest of the patients adjust the dose of medicine themselves, forget to take their medication when they have to leave home for a longer period of time, or double the dose of medicine when they forget to take one. Forgetfullness, long duration of medication, lack of funds and information, and unconvenient administration of the medicine are the main reasons of poor adherence to regimen. It also negatively influences the quality and fullness of life. The poorer the medication adherence the worse the wellbeing and the lower the index of the fullness of life.
Keyword(s): chronic heart failure; medication adherence; quality of life; fullness of life; beliefs about medicine.
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