KHẢO SÁT TUÂN THỦ ĐIỀU TRỊ THUỐC Ở BỆNH NHÂN SUY TIM MẠN TẠI PHÒNG KHÁM SUY TIM, KHOA NỘI TIM MẠCH, BỆNH VIỆN CHỢ RẪY

Abstract

Introduction: Heart failure is a clinical syndrome with high morbidity and mortality rates, leading to significant treatment costs for the general population. Poor medication adherence increases hospital readmission rates, disease burden, mortality, and healthcare expenses. Most studies on medication adherence in patients with chronic heart failure have been conducted abroad. Data on medication adherence in chronic heart failure patients in Vietnam remain limited. Objective: This study was conducted to evaluate the characteristics and determine the rate of medication adherence in patients with chronic heart failure at the Heart Failure Clinic, Department of Cardiology, Cho Ray Hospital, Vietnam. Subjects: Patients diagnosed with heart failure who had been receiving outpatient treatment for ≥1 month at the Heart Failure Clinic, Department of Cardiology, Cho Ray Hospital from September 2024 to February 2025. Study Design: Descriptive cross-sectional study. Results: A total of 306 patients met the inclusion criteria. The average age was 60.5 ± 14.9 years. Most participants were between 50 and 75 years old (64.3%), with a male-to-female ratio of 1.5:1. Nearly 3/5 (56.9%) had heart failure with reduced ejection fraction (HFrEF), and NYHA class II accounted for 59.2%. The medication adherence rate was 96.1%, while the non-adherence rate was 3.9%. The proportion of patients prescribed all four guideline-directed medical therapy (GDMT) drugs was 65.4%, and for those with HFrEF, it was 74.7%. The two most commonly prescribed drugs were SGLT2 inhibitors and beta-blockers at 91.8% and 94.4%, respectively, while ACE inhibitors were prescribed at a very low rate of 3.6%. Factors associated with medication adherence included gender, ethnicity, religion, heart failure classification by LVEF, use of health insurance, and financial status. Conclusion: The rate of medication adherence among patients with chronic heart failure was high (96.1%). The proportion of patients prescribed the four foundational drugs according to GDMT was relatively high (65.4%), particularly in patients with HFrEF (74.4%). Lack of health insurance, longer duration of heart failure, and financial difficulties were associated with poor adherence. Healthcare providers should pay attention to these vulnerable patient groups.