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

Soweto Cardiovascular Research Unit, Department of Cardiology, Chris Hani-Baragwanath Hospital, Soweto, Johannesburg, South Africa.
Cardiovascular journal of Africa (Impact Factor: 0.79). 01/2010; 21(2):86-92.
Source: PubMed

ABSTRACT 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.

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