Medication Adherence and Its Determinants Among Adults With Heart Failure: A Study in Selected Hospitals of North Shewa Zone, Oromia, Ethiopia (2024)—A Multicenter Institutional-Based Cross-Sectional Study

Abstract

Background: Effective management of heart failure (HF) critically relies on adherence to evidence-based pharmacotherapy. However, adherence remains suboptimal, contributing to preventable hospital readmissions, disease progression, and increased healthcare costs. This study assessed medication adherence and associated factors among adult HF patients in selected hospitals of North Shewa Zone, Oromia, Ethiopia. Methods: An institutional-based cross-sectional study was conducted among 327 adult HF patients selected via simple random sampling. The sample size was calculated using a single population proportion formula ( P = .738, 95% confidence interval [CI], 5% margin of error) and adjusted for a 10% non-response rate. Medication adherence was measured using the Amharic version of the Morisky Medication Adherence Scale (MMAS-8). Data were entered and analyzed using SPSS version 26. Logistic regression identified factors associated with adherence, with statistical significance set at P < .05. Results: Out of 327 participants, 165 (50.5%) were female, with a mean age of 43 ± 17.6 years. Good medication adherence was observed in 146 participants (44.65%). Independent predictors of adherence included higher HF knowledge (AOR = 2.03; 95% CI = 1.13-3.66; P = .018), access to free medications (AOR = 1.78; 95% CI = 1.04-3.03; P = .034), and receiving education on medication adherence (AOR = 2.20; 95% CI = 1.22-3.97; P = .009). Conclusion and Recommendations: Less than half of HF patients demonstrated good medication adherence. Structured patient education, reliable access to medications, and improved HF knowledge were key determinants of adherence. Interventions targeting these factors are strongly recommended to enhance medication adherence and improve clinical outcomes among HF patients in North Shewa Zone.