Title : Comparison between self-reported therapeutic adherence and biomarkers in patients with heart failure
Abstract:
Background
In Mexico, 135,748 people died from heart disease in 2025; one of the causes is low treatmen adherence, is assessed through self-reporting, where adherence is overestimated, limiting the effectiveness of the treatment.
Aim
To compare self-reported treatment adherence with biomarkers in heart failure (HF).
Methods
A cross-sectional study was conducted with 120 patients diagnosed with heart failure at the INER (Instituto Naciona de Enfermedades Respiratorias). Treatment adherence was assessed using the Martín-Bayarre-Grau (MBG) questionnaire, where a score of 48 or higher indicates full adherence. The biomarkers were also used: B-type natriuretic peptide (BNP), lipid profile, and glycated hemoglobin (HbA1c). Adherence based on biomarkers was defined as follows: a) full (5 biomarkers), b) partial (1 to 3 biomarkers), and c) no adherence (no biomarkers). Comparisons between MBG scores and biomarker scores were performed using the Mann-Whitney U test.
Results
The sample had a median age of 64 years, 48.7% were women (p<0.05).In the comparative analysis, no significant differences were found between the self-reported adherence classifications and the biomarker classifications (p>0.05). The median levels of biomarkers such as BNP and HbA1c in both groups were found to be upper optimal parameters, while the remaining biomarkers were at upper limits. 76% of patients reported full adherence; however, only 5% were found to have full adherence according to the biomarkers.
Conclusion
The difference between real and reported adherence shows a serious problem of underestimation of low adherence, since most studies report adherence measured by self-reports, and it is widely used in clinical practice, which has implications in different areas: symptoms, quality of life, use of hospital resources and even death.
To assess adherence, it is necessary to have complementary resources, since an erroneous measurement does not allow the identification of the need for care and intervention in patients, generating further deterioration in the quality of life and increasing the costs of medical care.
