Adherence to lifestyle therapy in patients with chronic heart failure and comorbidity

Abstract

Background: Influence of comorbidity on adherence to lifestyle therapy in patients with chronic heart failure (CHF) have not been studied yet. The aim of this study was to investigate awareness and adherence to lifestyle therapy in patients with CHF and comorbidity.Мethods: Two hundred and three patients with CHF (130 males and 73 females, mean age was 61.8±9.6 years) were studied. CHF was defined according to ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure, in 2016. Age-adjusted Charlson comorbidity index was calculated. Awareness of lifestyle modifications was determined using a questionnaire developed in our clinic and used in previous scientific studies. Quality of life was estimated using SF-36 Health Status Survey. Psychological state and attitude to condition were estimated using Minnesota Multiphasic Personality Inventory, the Personal Questionnaire of Behterevsk’ Institute, characterological questionnaire by K. Leonhard. Follow-up period was 1 year.Results: The awareness about lifestyle modifications in patients with CHF ranged from 38.9% (daily control of body weight) to 87.2% (limited salt intake). Adherence to lifestyle therapy was from 7.9% (daily weight control) to 37.9% (limited salt intake). Age-adjusted Charlson comorbidity index was 5.0±2.1 points. Patients with high comorbidity (Charlson comorbidity index >6 points) had decreased of quality of life, both in the physical and the psychological aspects. There were no differences in adherence to lifestyle therapy in patients with CHF, depending on comorbidity. Nonadherent patients were characterized by sensitive type of attitude to their condition, emotional lability, exclusion as a type of defense mechanism and negative coping strategies.Сonclusions: Nonadherence to lifestyle therapy in patients with CHF was associated with maladaptive type of attitude to their condition, which was more common in patients with high comorbidity.