Adherence to Medication, Mediterranean Diet, and Physical Activity and Their Predictors in Heart Failure Patients.

Background: Adherence to prescribed medications, a healthy diet, and regular physical activity is essential for the optimal management of heart failure (HF). Therefore, the present study aimed to determine the level of adherence to medications, the Mediterranean diet (MD), and physical activity, and to identify their correlations.

Methods: In this cross-sectional study, HF patients who were hospitalized from March to November 2022 were enrolled. Medication adherence, the MD, and physical activity were assessed using the 8-item Morisky medication adherence scale, the 14-item MD adherence Screener (MEDAS), and the International Physical Activity Questionnaire (IPAQ), respectively. Univariate analyses were conducted using the Chi square and Kruskal-Wallis tests. Ordinal logistic regression was applied to examine factors associated with adherence levels. Data were analyzed using Stata software (version 17), and P<0.05 was considered statistically significant.

Results: Data from 320 patients were analyzed. Suboptimal adherence was observed in 97 (30.3%), 88 (27.5%), and 224 (70%) of participants for medication, MD, and physical activity, respectively, and was linked to lower left ventricular ejection fraction. Multivariable analysis revealed that lower medication adherence was associated with older age, tobacco use, and a higher number of comorbidities. Reduced MD adherence was related to a higher body mass index (BMI), the presence of comorbidities, and a history of cerebrovascular accident or myocardial infarction. Lower physical activity levels were associated with older age, a higher BMI, a greater number of comorbidities, and a lower socioeconomic status.

Conclusion: In HF patients, nonadherence to medication, the MD, and physical activity were common and associated with poorer cardiac function and a greater comorbid burden. These findings underscore the importance of a multidisciplinary approach to enhance adherence and improve overall patient outcomes.