College of Health Sciences

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    Patients' Beliefs about Medications, Adherence to Treatment, and Drug-Drug Interactions in the Management of Heart Failure: A cross-sectional Study at Ayder Comprehensive Specialized Hospital, Northern Ethiopia
    (Mekelle University, 2025-06-12) Asmelash Araya Welecheal
    Background: Heart failure (HF) is the heart’s inability to pump blood effectively due to structural or functional impairments. Patients’ beliefs about medications, adherence, and drug-drug interactions are critical factors in heart failure managements and understanding these can enhance HF management and outcomes. Objective: To assess beliefs about medications, adherence levels, and the prevalence of drug-drug interactions in heart failure treatment. Method: A cross-sectional study was conducted from June 15 to August 30, 2024, with 314 HF patients selected via convenience sampling methods. Data was collected using the Beliefs about Medicines Questionnaire, Morisky Medication Adherence Scale-8, and DDInetr software. The analysis was performed in SPSS 27 using descriptive statistics, Mann-Whitney U, and Kruskal Wallis H tests (p < 0.05, 95% CI). Results: Among 314 participants, the median (IQR) age was 51.5 (32-65) years, 51.9% were female. The median treatment duration was four years. The mean score for specific necessity (20 ± 3.19), specific concern (15 ± 3.396), overuse (11.05 ± 2.297) and harm (9.03 ± 2.47) was scored. A majority of participants (79.3%) were classified as ambivalent, with a necessity-concern differential of +5.1. Non-adherence was observed in 41.4% of participants, with forgetfulness cited as the leading reason (37.6%). Significant correlations were found between adherence and both specific necessity (r = +0.27, p < 0.001) and harm beliefs (r = -0.27, p < 0.001). A total of 993 drug-drug interactions were identified, with moderate interactions being the most common and enalapril with Spironolactone was the drugs with sever interaction. These interactions were more prevalent among older patients and those experiencing polypharmacy. Conclusion: Overall heart failure patients have strong necessity belief than concern about their medication where 84.7% knows the benefit of their medication. Over half of the participants were adherent to their medication due to high necessity belief, low concern, and forgetfulness. Severe DDIs were less common (6.95%) but requires medical treatment. Collaborative healthcare efforts are key to improving positive beliefs, and adherence, and reducing DDIs for better HF outcomes.