NOVEL DIRECTION IN ADHERENCE ASSESSMENT — FOCUS ON THE GERIATRIC SYNDROMES

Abstract

Aim. To investigate on the factors determining the adherence to optimal treatment in older age patients with chronic heart failure (CHF) in outpatient setting.Material and methods. Into the open, comparative single-movement non-randomized study, 80 CHF patients were included at the age ≥60 y.o. Comparison group consisted of 40 patients (18 males, 22 females) with non-CHF cardiovascular disorders. Patients underwent the comorbidity assessment, laboratory and echocardiographic parameters, 6-minute walking test, cognitive status, treatment adherence, bi-photon x-ray absorptiometry. Criteria for frailty were 3 points by FRAIL (Fatigue, Resistance, Ambulation, Illnesses, Loss of Weight).Results. The adherent to treatment were 40% of CHF patients, and 75% in comparison group (p<0,001). In monofactorial analysis there was correlation of treatment adherence with the level of cognition by Mini-mental State Examination — odds ratio (OR) 1,5; 95% confidence interval (CI) 1,2-1,9 (р<0,001), frailty — OR 3,5; 95% CI 1,3-9,5 (р=0,011), osteoporosis — OR 2,98; 95% CI 1,0-8,9 (р=0,050), comorbidity by Charlson — OR 1,21; 95% CI 1,0-1,5 (р=0,050).Conclusion. Adherent to treatment were 40% of outpatients with CHF at the age ≥60 y.o. Multiple comorbidities, impaired cognition status, osteoporosis, frailty influenced negatively the adherence to treatment in older persons with CHF.

Keywords

• treatment adherence
• elderly
• heart failure
• frailty
• osteoporosis