Clinical Pharmacist Led-Educational Intervention to Promote Medications' Adherence for Sudanese Patients with Heart Failure: A Prospective Study

Abstract

Clinical pharmacists are in a suitable position to improve medications adherence for chronic diseases, including heart failure (HF). This study aimed to identify if the structured educational intervention by the clinical pharmacist can improve adherence to HF medications in a specialized HF clinic. Methods: A quasi-interventional study was implemented in an outpatient HF clinic for six months at Ahmed Gasim Cardiac Surgery and Renal Transplantation Center, Khartoum, Sudan. Adherence was assessed by using Morisky-4 Medication Adherence Scale (MMAS-4). Clinical pharmacist intervention using verbal and written materials composed of different aspects to promote medications adherence for HF were performed during the study period. Results: Among 110 patients, 97.3% were non-adherent to HF medications at baseline, with the exception of receiving education about HF; all sociodemographic and clinical characteristics of patients were not associated with the non-adherence status. Significant improvement in medication adherence was reported after clinical pharmacist intervention by different views of MMAS-4. There was a reduction in the total mean MMAS-4 score (2.64 ± 1.1 vs. 0.67 ± 0.9, P=0.001), and a significant increase in the percentage of patients having high adherence (2.7% vs. 56.4%, P=0.001) before and after clinical pharmacist intervention. By contrast, the proportion of patients with medium and low adherence was significantly reduced after intervention (42.7% vs. 37.3%, P=0.001) and (54.5% vs. 6.4%, P=0.001), respectively. Conclusion: Non-adherence was highly prevalent among Sudanese patients with HF; the clinical pharmacist led-educational intervention can improve medication adherence for HF medications.