Treatment adherence and prognosis in chronic heart failure

Evidence from a clinical follow-up program

Abstract

Introduction: heart failure is one of the main causes of morbidity and mortality worldwide. Adherence to pharmacotherapy is essential for improving clinical outcomes in these patients, but patient adherence is often suboptimal. This study evaluated the relationship between treatment adherence and clinical outcomes in patients with chronic heart failure in Barranquilla, Colombia.

Objective: to evaluate adherence to pharmacotherapy and its relationship to the clinical outcomes of patients with chronic heart failure who were enrolled in a follow-up program between 2021 and 2024.

Methods: this was a retrospective analytical study of 123 patients analyzing sociodemographic, clinical, and treatment variables. Nonparametric statistical tests, multivariate logistic regression, and a Kaplan-Meier survival analysis were employed.

Results: 34% of the patients were nonadherent. Those who were nonadherent had a higher frequency of ischemic disease and chronic kidney disease (CKD). Adherence was associated with significant improvements in left ventricular ejection fraction (LVEF), New York Heart Association (NYHA) functional class, and quality of life, along with fewer hospitalizations and deaths. Adherents had a higher 60-month survival rate (89.3% vs. 71.3%).
Conclusions: adherence to pharmacotherapy was associated with better clinical outcomes, lower mortality, and greater survival in patients with chronic heart failure. These findings reinforce the need for strategies to promote adherence in follow-up programs.