Pharmacist-Led Tailored Interventions to Adress Medication-Adherence Barriers and Improve Health-Related Quality of Life in Patients with Heart Failure: A Prospective Pre-Post Study

Abstract

Background: Nonadherence to heart failure (HF) therapy affects mortality and hospitalization. Pharmacists play a crucial role in addressing barriers to adherence; however, the implementation of tailored, patient-specific interventions has not been explored. Objective: To evaluate changes in medication adherence and health-related quality of life (QOL) following a pharmacist-led, barrier-spesific intervention among outpatients with chronic heart failure.  Methods: This prospective, single-centre, one-group pre-post study was conducted at the Cardiology and Vascular Polyclinic of a secondary hospital in Indonesia. Patients were observed over two months and received educational interventions, medication reminders, and simplified medication instructions. Medication adherence was assessed using the ARMS-7, while QOL was measured using SF-36. The McNemar test was used to assess medication adherence, and the Wilcoxon test was used to evaluate QOL improvement. Results: Forty participants completed the study, with more than half being male (aged < 60 years). The results indicated that forgetting to get prescriptions filled (85%) and forgetting to take medication (17.5%) were the major barriers to adherence to medication. Eighty percent of patients showed improved medication adherence (p < 0.05). Physical, mental, and social functions improved the most (p < 0.05). Conclusion: The findings underscore the effectiveness of a tailored intervention in significantly improving medication adherence and QOL among patients with HF, highlighting its ability to address specific barriers.