Medication adherence in heart failure with preserved ejection fraction: Impact on quality of life after one year

Authors

DOI:

https://doi.org/10.33448/rsd-v14i3.48487

Keywords:

Diastolic Heart Failure; Quality of Life; Medication Adherence.

Abstract

Introduction: Heart failure with preserved ejection fraction (HFpEF) accounts for more than 50% of prevalent heart failure (HF) cases worldwide. The pathophysiology of this condition is not yet fully understood, and the lack of consensus regarding therapeutic approaches and clinical outcome assessment creates a significant gap, requiring further research to develop more effective and targeted treatment strategies. Objective: To evaluate the relationship between medication adherence and quality of life in patients with HFpEF diagnosed for more than one year. Methods: This is a retrospective cohort study including patients with an HFpEF diagnosis for over one year who were in outpatient follow-up. Patients underwent a consultation to assess medication adherence and quality of life. Medication adherence was evaluated using the Morisky Medication Adherence Scale (MMAS-8), while quality of life was assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). In case of an event, patients provided hospital documentation for evaluation. Conclusion: The findings of this retrospective cohort study contribute to expanding the understanding of HFpEF, especially with regard to the relationship between medication adherence and quality of life. Although adherence to treatment is a central element in the management of HF, our results indicate that, in HFpEF, quality of life is influenced by multiple factors, including clinical conditions, comorbidities and socioeconomic characteristics.

References

ABC Cardiol. (2024). Qualidade de Vida em Insuficiência Cardíaca: Um Objetivo Importante no Tratamento.

https://abccardiol.org/short-editorial/qualidade-de-vida-em-insuficiencia-cardiaca-um-objetivo-importante-no-tratamento/

Andréa, S., Conde, B., Fragoso, E., Boléo-Tomé, J. P., Areias, V., Cardoso, J., ... & GI DPOC-Grupo de Interesse na Doença Pulmonar Obstrutiva Crónica. 1 (2018). COPD and Cardiovascular Disease. Pulmonology, 25(6), 355-362. https://doi.org/10.1016/j.pulmoe.2018.09.006

Bouzas, H., De Feo, A., Dias, A., et al. (2009). Identifying relative cut-off scores with neural networks for interpretation of the Minnesota Living with Heart Failure questionnaire. Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 2009. https://doi.org/10.1109/IEMBS.2009.5334659

Bocchi, E. A., Braga, F. G. M., Ferreira, S. M. A., et al. (2009). III Diretriz Brasileira de Insuficiência Cardíaca Crônica. Arquivos Brasileiros de Cardiologia, 93, 3-70. https://doi.org/10.1590/S0066-782X2009002000001

Cesarino, E. J., Castro, M. L., Andrade, R. C. G., Fonseca, M. V. L., Netto, E. R. A., Silva, G. S. D., et al. (2024). Impacto dos recentes estudos na prática clínica para a terapêutica da insuficiência cardíaca com fração de ejeção preservada (ICFEP). Revista SOCESP, 34(2).

Chen, X., Xin, Y., Hu, W., Zhao, Y., Zhang, Z., & Zhou, Y. (2019). Quality of life and outcomes in heart failure patients with ejection fractions in different ranges. PLoS One, 14(6), e0218983. https://doi.org/10.1371/journal.pone.0218983

Comissão Nacional de Incorporação de Tecnologias no SUS (CONITEC). (2022). Dapagliflozina para o tratamento adicional de pacientes adultos com insuficiência cardíaca com fração de ejeção reduzida (FEVE ≤ 40%), NYHA II-IV e sintomáticos apesar do uso de terapia padrão.

https://fi-admin.bvsalud.org/document/view/gx5g8

Dunlay, S. M., Roger, V. L., & Redfield, M. M. (2017). Epidemiology of heart failure with preserved ejection fraction. Nature Reviews Cardiology, 14(10), 591-602. https://doi.org/10.1038/nrcardio.2017.65

Fontes-Carvalho, R., & Leite-Moreira, A. (2011). Insuficiência cardíaca com fração de ejeção preservada: combater equívocos para uma nova abordagem. Arquivos Brasileiros de Cardiologia, 96, 504-514. https://doi.org/10.1590/S0066-782X2011000600012

Gusmão, J. L. de, & Mion Junior, D. (2006). Adesão ao tratamento. Revista Brasileira de Hipertensão, 23-25.

Hawkins, N. M., Virani, S., & Ceconi, C. (2013). Heart failure and chronic obstructive pulmonary disease: the challenges facing physicians and health services. European Heart Journal, 34(36), 2795–2807. https://doi.org/10.1093/eurheartj/eht192

Kitzman, D. W., Hundley, W. G., Brubaker, P. H., Morgan, T. M., Moore, J. B., Stewart, K. P., & Little, W. C. (2010). A randomized double-blind trial of enalapril in older patients with heart failure and preserved ejection fraction: effects on exercise tolerance and arterial distensibility. Circulation: Heart Failure, 3(4), 477-485. https://doi.org/10.1161/CIRCHEARTFAILURE.109.898916

Lima, J. G. de, Barros, A. L. B. L. de, & Lopes, J. de L. (2024). Factors associated with medication non-adherence among patients with heart failure. Revista Latino-Americana de Enfermagem, 32, e4302. https://doi.org/10.1590/1518-8345.6756.430

Lozada-Zapata, A., Piscoya, J., Shiraishi-Zapata, C., & Mendieta-Albañil, W. (2020). Calidad de vida y adherencia terapéutica en un programa de hipertensión arterial. Revista de Salud Pública, 22(6), 618-625. https://doi.org/10.15446/rsap.V22n6.88007

Mooney, L., Hawkins, N. M., Jhund, P. S., Redfield, M. M., Vaduganathan, M., Desai, A. S., et al. (2021). Impact of chronic obstructive pulmonary disease in patients with heart failure with preserved ejection fraction: Insights from PARAGON‐HF. Journal of the American Heart Association, 10(23).

Ogedegbe, A. D., Brathwaite, J. F., Norville, S. J., & Lindo, D. P. (2012). Association between the 8-item Morisky Medication Adherence Scale (MMAS-8) and blood pressure control. Arquivos Brasileiros de Cardiologia, 99(1). https://doi.org/10.1590/s0066-782x2012005000053

Penaforte, T. R. (2022). O sujeito e seu cuidado: a questão da adesão à medicação. Physis, 32(3), e320311. https://doi.org/10.1590/S0103-73312022320311

Pereira A. S. et al. (2018a). Metodologia da pesquisa científica. [free e-book]. Editora UAB/NTE/UFSM.

Pieske, B., Tschöpe, C., de Boer, R. A., et al. (2019). How to diagnose heart failure with preserved ejection fraction: the HFA-PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). European Heart Journal, 40(40). https://doi.org/10.1093/eurheartj/ehz641

Pitt, B., Pfeffer, M. A., Assmann, S. F., Boineau, R., Anand, I. S., Claggett, B., ... & McMurray, J. J. V. (2014). Spironolactone for Heart Failure with Preserved Ejection Fraction. New England Journal of Medicine, 370(15), 1383-1392. https://doi.org/10.1056/NEJMoa1313731

Reddy, Y. N. V., Carter, R. E., Obokata, M., Redfield, M. M., & Borlaug, B. A. (2018). A simple, evidence-based approach to help guide diagnosis of heart failure with preserved ejection fraction. Circulation, 138(9), 861–870. https://doi.org/10.1161/CIRCULATIONAHA.118.034646

Rohde, L. E. P., Montera, M. W., Bocchi, E. A., et al. (2018). Diretriz Brasileira de Insuficiência Cardíaca Crônica e Aguda. Arquivos Brasileiros de Cardiologia, 111(3), 436-539. https://doi.org/10.5935/abc.20180190

Sampaio, R. S., Pereira, M. G., & Winck, J. C. (2012). Adaptação Portuguesa do Questionário de Qualidade de Vida (SAQLI) nos doentes com Síndrome de Apneia Obstrutiva do Sono. Revista Portuguesa de Pneumologia, 18(2), 85-92. https://doi.org/10.1016/j.rppneu.2012.02.009

Serviços e Informações do Brasil. (2022). Doenças cardiovasculares: principal causa de morte no mundo pode ser prevenida. Recuperado em 12 de fevereiro de 2024, de https://www.gov.br/pt-br/noticias/saude-e-vigilancia-sanitaria/2022/09/doencas-cardiovasculares-principal-causa-de-morte-no-mundo-pode-ser-prevenida

Shitsuka, R. et al. (2014). Matemática fundamental para tecnologia. (2ed.). Editora Erica.

Vieira, S. (2021). Introdução à bioestatística. Editora GEN/Guanabara Koogan.

Published

18/03/2025

How to Cite

SILVA, J. R. N. da; SOUZA, V. L.; SIMONETTI, S. H. Medication adherence in heart failure with preserved ejection fraction: Impact on quality of life after one year. Research, Society and Development, [S. l.], v. 14, n. 3, p. e6014348487, 2025. DOI: 10.33448/rsd-v14i3.48487. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/48487. Acesso em: 3 jun. 2025.

Issue

Section

Health Sciences