Methods: A cross-sectional study explored prevalence and influencing factors of medication adherence in Thai patients with heart failure. The questionnaire from The New South Wales heart failure snapshot study including demographic, past illness history, treatment, frailty, depressive symptom and adherence were translated into Thai language. Participants are aged 18 years and over, were hospitalized with a confirmed diagnosis of heart failure and were able to communicate in Thai language from four tertiary hospitals in Thailand. The medication adherence score were reported and classified into three categories including good, moderate and poor adherence status. One-way ANOVA, Chi-Square and multiple linear regression were used to analyze the data.
Results: Three hundred and thirty-six participants were included in this study. Assessment of medication adherence found 54.3% had good adherence, 27% had moderate adherence and 18.4% had poor adherence. The significant predictors of medication adherence are depressive symptom (95%CI -0.17, -0.11 p<0.01), comorbidities (95%CI -0.31, -0.13 p<0.01), performance status (95%CI 0.01, 0.02 p=0.04), length of stay (95%CI -0.06, -0.01 p=0.04) when adjusting for sex, age, living status, income, smoking status, cardiac function and alcohol consumption. The selected model explained 35.2% of variance (F (4,330) = 46.26 p<0.01). To improve outcomes and adherence, Thailand has opportunities of universal healthcare coverage population and social support and networks and challenges on infrastructure availability, accessibility to healthcare.
Conclusion: During hospitalization, majority of Thai Heart Failure patients had good medical adherence. This adherence is influenced by multiple factors in personal, interpersonal and social levels. The opportunities and challenges of improving NCDs outcome suggested that nurse-led interventions are promise in this setting.