• Research Review
• Journal Review

Authors: V Ruf, S Stewart, S Pretorius, M Kubheka, et al.

Reference: Cardiovasc J Afr 2010; 21:86-92 (open access, number 4)
http://www.cvja.co.za/choice.php

Reviewer: Carlos Mendoza Montano, PhD, ProCor contributing editor; President, Guatemalan Association for the Prevention of Heart Diseases (APRECOR), Guatemala City, Guatemala

Reviewer comments: Results from high-income countries have shown that poor adherence to medical recommendations remains a substantial problem among people with chronic heart failure (CHF) who most follow a multi-component treatment regimen which includes medications, dietary restrictions and exercise recommendations. This study shows that CHF treatment is also a significant problem in South Africa because education about CHF is not optimal and knowledge on CHF medication and management is poor. The study confirms the need for comprehensive CHF programs in South Africa and other low-resource settings which should include easy access to medications and education for patients to optimize CHF management and outcomes.

Purpose of study: To examine the pattern of treatment adherence, self-care behavior and treatment knowledge in 200 consecutive patients attending a hospital in Soweto.

Location of study: Soweto, South Africa

Study design: To examine the patterns of self-care behavior, treatment adherence and treatment knowledge in the CHF patients, the investigators used a combination of questionnaires and pill count.

Results: The mean age of patients was 56 years, 79% were black African and 55% were male. CHF-specific treatment included loop diuretics (93%), beta-blockers (84%), ACE inhibitors (74%), spironolactone (64%) and cardiac glycosides (24%). Overall, 71% adhered to their prescribed CHF regimen and individual medication adherence ranged from 64% to 79%. Behavioral adherence varied from 2.5% to 98%. Patient treatment knowledge was low; 56% could not name medication effects or side effects. However, an average knowledge score of 69% was achieved on ten questions related to CHF management.

Additional references:
J McMurray, S Stewart. Epidemiology, aetiology and prognosis of heart failure. Heart 2000; 83:596-602. http://www.ncbi.nlm.nih.gov/pubmed/10768918

K Sliwa, A Damasceno, B Mayosi. Epidemiology and etiology of cardiomyopathy in Africa. Circulation 2005; 112: 3577-3583 (open access). http://www.circ.ahajournals.org/cgi/content/abstract/112/23/3577