Improving awareness and adherence to medications amongst heart failure patients is the most cost effective way of reducing healthcare costs.

Title : Improving awareness and adherence to medications amongst heart failure patients is the most cost effective way of reducing healthcare costs.

Abstract:

Background: Heart Failure (HF) is a common medical condition and an important public health issue.  This carries with it high mortality and frequent hospitalization. There is generally high re-admission rate and patients of heart failure tend to have a duration of stay in the hospital. Heart failure management is costly and puts a burden on healthcare budget. Lack of awareness of different aspects of management of heart failure leads to poor adherence  to  treatment which  further  adds  to  the  healthcare  cost. Despite a number of evidence based medications being available, the utilization  are not always  satisfactory. 

Objective: We  conducted  a  study  to explore  patients’  understanding  and  adherence  to  Heart Failure (HF) medications  at  a  general  hospital  setting.

Materials and Methods: We prospectively studied from January 2016 till  December  2017,  196  patients  (outpatients  plus  inpatients )  of  HF  at  our hospital  .  The  information  was  gathered  by  oral interview  as  well  as  using questionnaire .

Results: There   were 110 male and 86 female patients with average age of 54 years.  The majority of patients (78% ) were  in NYHA  class  II  and  III  and  72% of patients  were from Outpatient  visits.

15%  of patients  stopped  or reduced  the dose  of diuretics  on their  own  as  they  thought  they didn’t  need  them anymore  or they were  thought to interfere  in their life style.  36 % patients  believed  that  ACE Inhibitors  or ARBs were  for blood  pressure  and therefore  they had either  stopped  or were intending to stop.  43 %  patients  were  not keen on   taking  beta-blocker  because  of fear of various  side effects  and  12% of  them  already  stopped  the  beta-blocker on their own. 56% of patients  did  not like  the idea of increasing the  dose of ACE  Inhibitor  , ARBs  or beta-blocker  to the maximum, mainly out of fear  of side effects. In addition, 54% of the patients  reported  that they were not informed  by  the prescribing  physician regarding  the  purpose and benefits  of up titrating  the  dose of these  medication.    Patients  were  ignorant  of the  role  of different  HF  medications  such as Aldosterone  antagonists  (86% ), ACE Inhibitor  or ARBs (76% ) , Beta blocker ( 70% ).  None  of the patients  who were on Ivabradine  knew  the  role of the  drug  in HF but  at the  same time were  not informed of any known  side effects.

Conclusion: Inadequate understanding and poor adherence to medications is a common problem among heart failure (HF) patients. as shown in our study. Inadequate adherence leads to increased HF de-compensation, reduced exercise tolerance, poor quality of life and higher risk for hospital admission and death. They all lead to increase in   heart failure  treatment and management  costs.

Biography:

Dr Syed  Raza  graduated from Aligarh University in India  in 1993. After completing his postgraduate degree in Medicine from the same university, he moved to the UK for higher specialist studies. He successfully completed MRCP and CCT and later also  awarded Fellow of the Royal College of Physicians of Edinburgh (FRCP ). He was awarded Professor John Goodwin prize for outstanding performance in Diploma Cardiology exam  at Hammersmith Hospital, University of London in 2001.  Dr  Raza  is  Fellow  of  American  College  of  Cardiology and American  College  of  Chest  Physicoans. He is also Fellow  of  European  Society  of  Cardiology and Fellow of European Society of Cardiovascular Imaging. He  is  also  on  the  committee  of  Acute  Cardiovascular  Care.  Heart  Failure  and  Cardiovascular  Imaging (European  Society of  Cardiology).

He is currently  working as Consultant  Cardiologist and Head of the department of Medicine  at Awali Hospital, Bahrain. Dr Raza is  a board member of the Hospital Excecutive Committee. He  also chairs  the  Resuscitation  committee  and Privileging and Credentialing Committee. Prior to this he worked as  consultant in Cardiology at  Mid Cheshire  Hospitals, NHS trust, United  Kingdom. He is the regional educational coordinator for RCP Edinburgh  and examiner for  MRCP  exam for the Royal College of Physicians of UK. He has partipcpated in some well known trials and reasearch. He has to his credit  numerous publications and he has presented his scietific work in  different parts of the world. He is peer review author for some well respected International  journals. He is permanent  Review author for abstracts for European Society of Cardiology Annual Congress.

He is on the  editorial board of  International Journal of Endovasculat Treatment and Innovative Techniques. Dr Raza  is  a  teaching  faculty member  for  Healthcare  Management  and  Leadership at  Westford University, Dubai  campus. He is certified  American Board in Medical  Quality. Dr Raza frequently  organises  a  number  of  seminars, webinars, symposia  and  workshop  on various  healthcare, quality and  safety  topics. Dr  Raza  has  led  the  first  awareness  campaign in Heart Failure in the  Middle East  in 2017. He is  chairman  of  BAPCO's   health  promotion unit. His  special interests are Cardiovascular Imaging, Heart Failure and Acute Cardiovascular Care. He is  founder and chairman  of  Raza   Foundations  which  works  for  educating  and  increasing  awareness on various  health related  topics  amongst the  general  public  as  well  as  provide  free  healthcare  services to  poor  as  one  of  the  charity  initiatives.