Medication adherence, self-care behaviour and knowledge on heart failure in urban South Africa: the Heart of Soweto study

• Published in: Cardiovascular Journal of Africa Vol. 21; no. 2; pp. 86 - 92
• Main Authors: Ruf, V, Stewart, S, Pretorius, S, Kubheka, M, Lautenschläger, C, Presek, P, Sliwa, K
• Format: Journal Article
• Language: English
• Published: South Africa Clinics Cardive Publishing 01.03.2010
• Subjects: Cardiovascular Agents - therapeutic use; Cardiovascular Topics; Female; Heart Failure - drug therapy; Heart Failure - epidemiology; Humans; Male; Medication Adherence - statistics & numerical data; Middle Aged; Patient Education as Topic - statistics & numerical data; Prevalence; Self Care - psychology; South Africa - epidemiology; Surveys and Questionnaires; South Africa
• ISSN: 1995-1892; 1996-3467; 1680-0745

There is a paucity of data on treatment adherence in patients with chronic heart failure (CHF) in Africa. We examined the pattern of treatment adherence, self-care behaviour and treatment knowledge in 200 consecutive patients with CHF attending the Chris Hani Baragwanath Hospital, Soweto, South Africa via a combination of questionnaire (100%, n = 200) and pill count (41%, n = 82). Mean age was 56 +/- 14 years, 157 were black African (79%) and 109 (55%) were male. CHF-specific treatment included loop diuretics (93%), beta-blockers (84%), ACE inhibitors (74%), spironolactone (64%) and cardiac glycosides (24%); mean number of medications was 6 +/- 2. Overall, 71% (58 of 82) adhered to their prescribed CHF regimen and individual medication adherence ranged from 64 to 79%. Behavioural adherence varied from 2.5 to 98%. Patient treatment knowledge was poor; 56% could not name medication effects or side effects. However, an average knowledge score of 69% was achieved on 10 questions concerning CHF management. As in other regions of the world, non-adherence to complex CHF treatment is a substantial problem in Soweto. Our data confirm the need for a dedicated CHF management programme to optimise CHF-related outcomes in a low-resource environment.