Medication adherence, self-care behaviour and knowledge on heart failure in urban South Africa: the Heart of Soweto study.
BACKGROUND
There is a paucity of data on treatment adherence in patients with chronic heart failure (CHF) in Africa.


METHODS
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).


RESULTS
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.


CONCLUSIONS
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.
Soweto Cardiovascular Research Unit, Department of Cardiology, Chris Hani-Baragwanath Hospital, Soweto, Johannesburg, South Africa.
V
V
Ruf
S
S
Stewart
S
S
Pretorius
M
M
Kubheka
C
C
Lautenschläger
P
P
Presek
K
K
Sliwa
D002317:Cardiovascular Agents / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D015995:Prevalence; D012648:Self Care / Q000523:psychology*; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires; D016903:Drug Monitoring
D002317:Cardiovascular Agents