Treatment adherence in patients with heart failure in the Internal Medicine and Cardiology Department of the Hospital de Clínicas, San Lorenzo, Paraguay
DOI:
https://doi.org/10.30545/scientiamericana.2026.304Keywords:
Heart failure, treatment adherence, arterial hypertension, diabetes mellitus, dyslipidemiasAbstract
Introduction: Adherence to heart failure treatment is the degree of patient adherence to medication, diet, and lifestyle changes that are consistent with physician recommendations. Objective: To determine the level of treatment adherence in patients with heart failure attending the Internal Medicine and Cardiology Department of Hospital de Clinicas, San Lorenzo, Paraguay, in 2025. Methodology: An observational, cross-sectional, descriptive study with cross-reference association and non-probability sampling of patients diagnosed with heart failure who attended the Internal Medicine and Cardiology Department of Hospital de Clínicas, from June to August 2025. Sociodemographic and clinical variables, as well as adherence to heart failure treatment, were measured. A validated instrument was used to assess treatment adherence, and the level of adherence was assessed using the following scales: non-adherent, low adherence, frequently adherent, and adherent. Results: Low adherence predominates in the general population and by sex. The level of adherence is related to marital status (married and in a stable union), functional class I and II of heart failure, and the place of consultation (Cardiology office). Conclusion: In the general population and by sex, poor treatment adherence predominates, and the level of adherence is related to marital status, heart failure functional class I, and the location of the consultation.
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1. GBD 2021 Causes of Death Collaborators. Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Lond Engl. 2024;403(10440):2100-32. https://doi.org/10.1016/S0140-6736(24)00367-2
2. Calazans JA, Queiroz BL. The adult mortality profile by cause of death in 10 Latin American countries (2000–2016). Rev Panam Salud Pública. 2020;44:1. https://doi.org/10.26633/RPSP.2020.1
3. Brake R, Jones ID. Chronic heart failure part I: pathophysiology, signs and symptoms. Nurs Stand. 2017;31(19):54-63. https://doi.org/10.7748/ns.2017.e10349
4. Oriani A, Guo P, Gadoud A, Dunleavy L, Kane P, Murtagh FEM. What are the main symptoms and concerns reported by patients with advanced chronic heart failure? -a secondary analysis of the Palliative care Outcome Scale (POS) and Integrated Palliative care Outcome Scale (IPOS). Ann Palliat Med. 2019;8(5):775-80. https://doi.org/10.21037/apm.2019.08.10
5. Molano Barrera D, González Consuegra RV. Factores deteriorantes de la calidad de vida en insuficiencia cardiaca: revisión integrativa. Duazary Rev Int Cienc Salud. 2021;18(1):86-98. https://doi.org/10.21676/2389783X.3889
6. Valle-Ballesteros R, Torres-Navas A, Cortés-Muñoz F, Vargas-Escobar LM. Funcionalidad familiar de pacientes dependientes con falla cardíaca. Rev Colomb Cardiol. 2021;28(1):30-37. https://doi.org/10.24875/rccar.m21000006
7. G-CHF Investigators, Joseph P, Roy A, Lonn E, Störk S, Floras J, et al. Global variations in heart failure etiology, management, and outcomes. JAMA. 2023;329(19):1650-61. https://doi.org/10.1001/jama.2023.5942
8. Silva AF da, Cavalcanti ACD, Malta M, Arruda CS, Gandin T, Fé A da, et al. La adherencia al tratamiento de pacientes con insuficiencia cardiaca acompañados de enfermeras en dos clínicas especializadas. Rev Lat Am Enfermagem. 2015;23(5):888-94. https://doi.org/10.1590/0104-1169.0268.2628
9. Mora-Pabón G, Méndez-Toro A, Rojas-Ruiz IT, Bautista-Triana JE. Caracterización y evaluación de adherencia al programa Get With The Guidelines en pacientes con insuficiencia cardíaca aguda en un hospital de Bogotá, 2016-2018: Cohorte HUN-ICA. Medicas UIS. 2023;36(2):37-50. https://doi.org/10.18273/revmed.v36n2-2023004
10. Rojas Sánchez LZ, Echeverría Correa LE, Camargo Figuera FA. Adherencia al tratamiento farmacológico y no farmacológico en pacientes con falla cardiaca. Enferm Glob [Internet]. 2014 [citado 2025 octubre 16] ;13(36):1-19. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1695-61412014000400001&lng=e
11. Kukulska A, Garwacka-Czachor E. Assessment of adherence to treatment recommendations among patients with heart failure: a cross-sectional study. BMC Cardiovasc Disord. 2024;24(1):337. https://doi.org/10.1186/s12872-024-04001-y
12. Nakanishi M, Miura H, Irie Y, Nakao K, Fujino M, Otsuka F, et al. Association of adherence to a 3-month cardiac rehabilitation with long-term clinical outcomes in heart failure patients. ESC Heart Fail. 2022;9(2):1424-35. https://doi.org/10.1002/ehf2.13838
13. Sicras Mainar A, Navarro Artieda R, Ibáñez Nolla J. Impacto económico de la insuficiencia cardiaca según la influencia de la insuficiencia renal. Rev Esp Cardiol. 2015;68(1):39-46. https://doi.org/10.1016/j.recesp.2014.02.023
14. Achury Saldaña DM, Sepúlveda Carrillo GJ, Rodríguez Colmenares SM, Giraldo IC. Validez y confiabilidad de un instrumento evaluativo de adherencia en pacientes con falla cardiaca. Enferm Glob. 2012;11(26):01-9. https://dx.doi.org/10.4321/S1695-61412012000200001
15. Suárez SJJ, Acuña DM, Hoyos MMP. Relación entre nivel de adherencia al tratamiento y apoyo social en pacientes con falla cardiaca. Investig en Enferm Imagen Desarro. 2021;23:1-8. https://doi.org/10.11144/Javeriana.ie23.rnat
16. Giezeman M, Arne M, Theander K. Adherence to guidelines in patients with chronic heart failure in primary health care. Scand J Prim Health Care. 2017;35(4):336-43. https://doi.org/10.1080/02813432.2017.1397253
17. Seid E, Engidawork E, Alebachew M, Mekonnen D, Berha AB. Evaluation of drug therapy problems, medication adherence and treatment satisfaction among heart failure patients on follow-up at a tertiary care hospital in Ethiopia. PloS One. 2020;15(8):e0237781. https://doi.org/10.1371/journal.pone.0237781
18. Huamán Guerra AG. Asociación entre el cumplimiento y adherencia al tratamiento con la calidad de vida en pacientes con insuficiencia cardiaca crónica. Enferm Cardiol [Internet]. 2019 [citado 2025 octubre 16] ;26(78):74-81. Disponible en: https://www.enfermeria21.com/revistas/cardiologia/articulo/555/asociacion-entre-el-cumplimiento-y-adherencia-al-tratamiento-con-la-calidad-de-vida-en-pacientes-con-insuficiencia-card%C3%ADaca-cronica/
19. Miró Ò, Martín-Sánchez FJ, Jacob J, Andueza JA, Herrero P, Llorens P. Valoración del grado de adherencia a la dieta mediterránea en pacientes con insuficiencia cardiaca: estudio DIME-EAHFE. An Sist Sanit Navar [Internet]. 2016 [citado 2025 octubre 16];39(2):261-268. https://dialnet.unirioja.es/servlet/articulo?codigo=5627392
20. Turro Mesa LN, del Río Caballero G, Turro Caró E, Mesa Valiente RM. Características clínicas y epidemiológicas en pacientes hospitalizados por insuficiencia cardiaca. MEDISAN [Internet]. 2023 [citado 2025 octubre 16] ;27(3):2. Disponible en: https://pesquisa.bvsalud.org/portal/resource/pt/biblio-1514542
21. Rojano-Rada JA, Suárez-Marcano S. Impact of adherence to pharmacological treatment on quality of life in patients with heart failure. Med Int Mex. 2021;37(5):665-673. https://doi.org/10.24245/mim.v37i5.4220
22. Sánchez-Prieto Castillo J, López Sánchez FA. Insuficiencia cardíaca. Generalidades. Med - Programa Form Médica Contin Acreditado. 2017;12(35):2085-91. https://doi.org/10.1016/j.med.2017.06.001
23. Andrade R, Pérez V, Silvera G, Andrade R, Pérez V, Silvera G. Manejo de las comorbilidades en la insuficiencia cardíaca. Rev Urug Cardiol. 2018;33(1):43-80. http://dx.doi.org/10.29277/cardio.33.1.1
24. Vega JDS, Luque MCA, Salinas GLA, Gómez JLZ. Actualización clínica: insuficiencia cardíaca, concepto y clasificación. Med - Programa Form Médica Contin Acreditado. 2021;13(35):2011-7. https://doi.org/10.1016/j.med.2021.06.001
25. Biddle MJ, Moser DK, Pelter MM, Robinson S, Dracup K. Predictors of adherence to self-care in rural patients with heart failure. J Rural Health off J Am Rural Health Assoc Natl Rural Health Care Assoc. 2020;36(1):120-9. http://dx.doi.org/10.1111/jrh.12405
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