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To investigate adherence and non-adherence to treatment regimens among heart failure patients and to explore relationships with symptom burden and hospitalisation frequency.
The research employed a cross-sectional survey study design.
The online survey “Living with heart failure”, was conducted among patients attending the Cardiac outpatient clinic at a Swedish University Hospital over the course of a calendar year. Data analysis employed descriptive statistics using the statistical processing program SPSS.
The survey was made accessible to 1395 respondents; 479 individuals participated. The response rate was 34.3%. 73.6% were classified as non-adherent and 26.4% as adherent. Among the non-adherent, a statistically significantly higher symptom burden was observed. Lower hospitalisation frequency was associated with higher adherence and lower symptom burden. Frequent hospitalisations correlated with lower adherence and more severe symptoms.
This study underscores the prevalence of non-adherence in the heart failure population and emphasises the importance of addressing this issue.
Non-adherence to treatment regimens remains a global challenge, historically underestimated and challenging to quantify. Non-adherence to medical treatment in the heart failure population is about 50%; non-adherence from a wider perspective implicates a gap of knowledge. The principal discoveries from this study underscore the extensive non-adherence and its exacerbating effects on symptom burden and hospitalisation. The primary significance of this research will manifest among caregivers in multidisciplinary teams providing support to the heart failure population.
The Equator Guidelines Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) were adhered to.
No patient or public contribution.
Post-traumatic neck pain is common, representing a substantial human and societal burden. About 15%–25% of individuals involved in an accident causing whiplash continue to experience moderate-to-severe symptoms and functional impairment 1 year post-trauma. Factors such as age, high pain intensity, hypersensitivity to pain and early post-traumatic hyperarousal are associated with persistent neck pain. However, multiple questions remain unanswered regarding how best to improve early care. As such, research on recovery patterns (including indicators for health economic burden) and their predictors is still needed, including biomarkers for pre-traumatic and peri-traumatic stress, and the value of early prediction tools.
This prospective cohort study will include 100 participants (≥18 years) suffering from post-traumatic neck pain sustained within 72 hours of an accident. At baseline (a combination of inclusion and 1 week assessment), eligible participants will undergo a thorough evaluation, including assessment of descriptive characteristics, self-reported variables (eg, pain, disability, sleep quality and post-traumatic stress), biomarkers (eg, heart rate variability (HRV) and hair cortisol) and clinical tests (eg, cervical range of motion). Follow-up will be conducted at 3, 6 and 12 months post-trauma. Further, register data (eg, data on labour market attachment) will be added for the period. Among other methods, a receiver operating characteristic (ROC) curve and multivariable regression analyses will be used to evaluate performance and associations of the prediction tools and their associations with measures of HRV.
The sample size calculation is based on previous studies, estimating that 15% of participants will develop moderate-to-severe ongoing symptoms. Using a conservative estimate, 64 participants are needed to achieve a statistical power of 90% with an expected area under the curve of 0.80. Accounting for a 25% loss to follow-up, 80 participants are required. For regression analysis, 100 participants will be included. The prediction tool will be validated using ROC analysis, sensitivity and specificity. Logistic regression models will be performed with and without biomarkers and pain sensitivity. Health economic costs will be compared across groups. Multivariable regression will examine the link between HRV and post-traumatic stress disorder, adjusting for confounders and a moderation analysis will assess hair cortisol as a potential moderator.
The study is approved by the Regional Committee on Health Research Ethics of Southern Denmark (S-20230037). Due to the acute nature of recruitment, the study design does not allow for a 24-hour reflection period; however, this approach has been approved by the Committee.
Study results will be published in peer-reviewed journals and disseminated through non-scientific outlets, including patient and professional publications, press releases and social media. If effective, workshops for clinicians will be organised. Results will be published regardless of outcome, with coauthorships following ICMJE guidelines.
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