Life quality and treatment adherence in elderly outpatients with heart failure: Data from an observational study
Abstract. Low treatment adherence is a pressing issue that significantly impacts the life quality (LQ) of multimorbid patients. The aim: to assess LQ and treatment adherence in elderly outpatients with chronic heart failure (CHF). Material and methods. The study included 90 outpatients – 32 male and 58 female individuals (median age 74 [67; 84] years). They were divided into two groups based on the presence of CHF: patients with this condition (n = 53) and those without it (n = 37). Additional analysis was made in the age subgroups 60–74 and ≥ 75 years. Various scales and questionnaires were used for clinical estimation of patients, and the Short Form-36 (SF-36) questionnaire was used to assess LQ. Treatment adherence was determined using the National Society for Evidence-Based Pharmacotherapy (NSEBP) scale. Results. Participants with CHF showed a more pronounced decrease in LQ indexes comparatively to patients without CHF. The most significant differences were found in SF-36 questionnaire scales reflecting the physical component of health, the total index of which was lower in the CHF group across all age subgroups. That indicates the leading role of functional limitations in the decline of LQ in this patient category (p <0.05). Logistic regression analysis revealed that deterioration in functional mobility, assessed by the time it takes to complete the “Get-up and Go” test, was associated with a reduced probability of full adherence to medication therapy (odds ratio 0.795; 95% confidence interval: 0.647–0.976; p = 0.029). Conclusion. Elderly and senile patients with CHF have a more pronounced decline in LQ parameters comparatively to patients without CHF, primarily due to physical functioning deterioration. CHF is also associated with a higher prevalence of geriatric disorders and reduced functional mobility. The obtained data indicate a possible role of functional limitations in the formation of treatment adherence and highlight the need for a comprehensive assessment of geriatric factors in the management of older patients having CHF.V.N. Larina, E.S. Shcherbina, T.A. Matveychuk
Keywords
chronic heart failure
life quality
treatment adherence
fear of falls
References
1. Николаев Н.А., Мартынов А.И., Скирденко Ю.П., Авдеев В.Н., Анисимов В.Н., Арутюнов Г.П. с соавт. Приверженность лечению. Российское национальное руководство. М.: Издательский дом «Академия естествознания». 2022; 224 с. (Nikolaev NA, Martynov AI, Skirdenko YuP, Avdeev VN, Anisimov VN, Arutyunov GP et al. Adherence to treatment. Russian national guidelines. Moscow: Academy of Natural Sciences Publishing House. 2022; 224 pp. (In Russ.)).
ISBN: 978-5-91327-746-6. EDN: VMWTIF. https://doi.org/10.17513/np.541
2. Burnier M, Egan BM. Adherence in hypertension. Circ Res. 2019;124(7):1124–40.
PMID: 30920917. https://doi.org/10.1161/CIRCRESAHA.118.313220
3. Фомин И.В., Беленков Ю.Н., Мареев В.Ю., Агеев Ф.Т., Артемьева Е.Г., Бадин Ю.В. с соавт. ЭПОХА-ХСН – зеркало проблем лечения сердечно-сосудистых заболеваний в реальной клинической практике. Кардиология. 2024;64(11):48–61. (Fomin IV, Belenkov YuN, Mareev VYu, Ageev FT, Artemyeva EG, Badin YuV et al. EPOCH-CHF as a mirror of the current problems in cardiovascular diseases treatment in real clinical practice. Kardiologiia = Cardiology. 2024;64(11):48–61 (In Russ.)).
EDN: NNVIFP. https://doi.org/10.18087/cardio.2024.11.n2808
4. Poletti V, Pagnini F, Banfi P, Volpato E. The role of depression on treatment adherence in patients with heart failure – a systematic review of the literature. Curr Cardiol Rep. 2022;24(12):1995–2008.
PMID: 36327056. PMCID: PMC9747824. https://doi.org/10.1007/s11886-022-01815-0
5. Хидирова Л.Д., Яхонтов Д.А., Мадонов П.Г. Оценка приверженности к терапии у коморбидных больных. Артериальная гипертензия. 2023;29(1):109–118. (Khidirova LD, Yakhontov DA, Madonov PG. Assessment of adherence to therapy in comorbid patients. Arterial’naya gipertenziya = Arterial Hypertension. 2023;29(1):109–118 (In Russ.)).
EDN: QHBNUN. https://doi.org/10.18705/1607-419X-2022-28-6-109-118
6. Калайджян Е.П., Кутишенко Н.П., Марцевич С.Ю., Драпкина О.М. Оценка влияния приверженности лечению на выживаемость при длительном наблюдении у пациентов, перенесших острый инфаркт миокарда, по данным регистра ПРОФИЛЬ-ИМ. Рациональная фармакотерапия в кардиологии. 2025;21(6):571–577. Кalaydzhian EP, Martsevich SYu, Kutishenko NP, Drapkina OM. Impact of treatment adherence on survival during long-term follow-up in patients after acute myocardial infarction: data from the PROFILE-IM registry. Ratsional’naya farmakoterapiya v kardiologii = Rational Pharmacotherapy in Cardiology. 2025;21(6):571–577 (In Russ.)).
EDN: DFJZHA. https://doi.org/10.20996/1819-6446-2025-3254
7. Comin-Colet J, Martin Lorenzo T, Gonzalez-Dominguez A, Oliva J, Jimenez Merino S. Impact of non-cardiovascular comorbidities on the quality of life of patients with chronic heart failure: a scoping review. Health Qual Life Outcomes. 2020; 18(1):329.
PMID: 33028351. PMCID: PMC7542693. https://doi.org/10.1186/s12955-020-01566-y
8. Терещенко С.Н., Галявич А.С., Ускач Т.М., Агеев Ф.Т., Арутюнов Г.П., Беграмбекова Ю.Л. с соавт. Клинические рекомендации. Хроническая сердечная недостаточность. Российский кардиологический журнал. 2020;25(11):311–374. (Tereshchenko SN, Galyavich AS, Uskach TM, Ageev FT, Arutyunov GP, Begrambekova YuL et al. Clinical practice guidelines for chronic heart failure. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2020;25(11):311–374 (In Russ.)).
EDN: LJGGQV. https://doi.org/10.15829/1560-4071-2020-4083
9. Ткачева О.Н., Котовская Ю.В., Рунихина Н.К., Фролова Е.В., Наумов А.В., Воробьева Н.М. с соавт. Клинические рекомендации «Старческая астения». Российский журнал гериатрической медицины. 2020;(1):11–46. (Tkacheva ON, Kotovskaya YuV, Runikhina NK, Frolova EV, Naumov AV, Vorobyeva NM et al. Clinical guidelines on frailty. Rossiyskiy zhurnal geriatricheskoy meditsiny = Russian Journal of Geriatric Medicine. 2020;(1):11–46 (In Russ.)).
EDN: JCMOSK. https://doi.org/10.37586/2686-8636-1-2020-11-46
10. Tinetti ME, Richman D, Powell L. Falls efficacy as a measure of fear of falling. J Gerontol. 1990;45(6):P239–P243.
PMID: 2229948. https://doi.org/10.1093/geronj/45.6.p239
11. Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 Health Survey. Manual and interpretation guide. The Health Institute, New England Medical Center. Boston, Mass. 1993. URL: https://www.researchgate.net/profile/John-Ware-6/publication/313050850_SF-36_Health_Survey_Manual_Interpretation_Guide/links/594a5b83aca2723195de5c3d/SF-36-Health-Survey-Manual-Interpretation-Guide.pdf (date of access – 17.11.2025).
12. Лукина Ю.В., Кутишенко Н.П., Марцевич С.Ю., Драпкина О.М. Разработка и валидизация новых опросников в медицине на примере шкалы приверженности лекарственной терапии. Рациональная фармакотерапия в кардиологии. 2021;17(4):576–83. Lukina YuV, Kutishenko NP, Martsevich SYu, Drapkina OM. The Questionnaire Survey Method in medicine on the example of treatment adherence scales. Ratsional’naya farmakoterapiya v kardiologii = Rational Pharmacotherapy in Cardiology. 2021;17(4):576–83 (In Russ.)).
EDN: LBFQNW. https://doi.org/10.20996/1819-6446-2021-08-02
13. Borgstrom F, Karlsson L, Ortsater G, Norton N, Halbout P, Cooper C et al.; International Osteoporosis Foundation. Fragility fractures in Europe: Burden, management and opportunities. Arch Osteoporos. 2020;15(1):59.
PMID: 32306163. PMCID: PMC7166207. https://doi.org/10.1007/s11657-020-0706-y
14. Торопцова Н.В., Никитинская О.А., Добровольская О.В. Приверженность лечению больных остеопорозом в реальной клинической практике. Научно-практическая ревматология. 2014;52(3):336–341. (Toroptsova NV, Nikitinskaya OA, Dobrovolskaya OV. Treatment adherence in patients with osteoporosis in daily clinical practice. Nauchno-prakticheskaya revmatologiya = Rheumatology Science and Practice. 2014;52(3):336–341 (In Russ.)).
EDN: SMYFRD. https://doi.org/10.14412/1995-4484-2014-336-341
15. Jorge AJL, Rosa MLG, Correia DMDS, Martins WA, Ceron DMM, Coelho LCF et al. Evaluation of quality of life in patients with and without heart failure in primary care. Arq Bras Cardiol. 2017;109(3):248–52.
PMID: 28832746. PMCID: PMC5586232. https://doi.org/10.5935/abc.20170123
16. Кужелева Е.А., Федюнина В.А., Гарганеева А.А. Приверженность лечению и качество жизни больных сердечно-сосудистыми заболеваниями на амбулаторном этапе оказания медицинской помощи. Евразийский кардиологический журнал. 2020;(2):34–40. (Kuzheleva EA, Fedyunina VA, Garganeeva AA. Adherence to treatment and quality of life of patients with cardiovascular diseases at the outpatient treatment stage of medical care. Yevraziyskiy kardiologicheskiy zhurnal = Eurasian Heart Journal. 2020;(2):34–40 (In Russ.)).
EDN: TMKTUO. https://doi.org/10.38109/2225-1685-2020-2-34-40
17. Ларина В.Н., Замятин К.А., Гудиев Ч.Г. Уровень приверженности лечению пациентов с хронической сердечной недостаточностью: пилотное обсервационное исследование в амбулаторной практике. Российский кардиологический журнал. 2024;29(S12):14–21. (Larina VN, Zamyatin KA, Gudiev ChG. Medication adherence in patients with heart failure: A pilot observational study in outpatient practice. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2024;29(S12):14–21 (In Russ.)).
EDN: OBICSP. https://doi.org/10.15829/1560-4071-2024-6180
18. Sharma R, Sharma T, McCready-Branch B, Chauhan A, Carter C, Park S et al. Medication use by older adults with frailty: A scoping review. Pharmacy. 2025;13(6):170.
PMID: 41283631. PMCID: PMC12641866. https://doi.org/10.3390/pharmacy13060170
19. Галявич А.С., Терещенко С.Н., Ускач Т.М., Агеев Ф.Т., Аронов Д.М., Арутюнов Г.П. с соавт. Хроническая сердечная недостаточность. Клинические рекомендации 2024. Российский кардиологический журнал. 2024;29(11):251–349. (Galyavich AS, Tereshchenko SN, Uskach TM, Ageev FT, Aronov DM, Arutyunov GP et al. Clinical practice guidelines for chronic heart failure. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2024;29(11):251–349 (In Russ.)).
EDN: WKIDLJ. https://doi.org/10.15829/1560-4071-2024-6162
About the Authors
Vera N. Larina, MD, Dr. Sci. (Medicine), professor, head of the Department of outpatient therapy of the Institute of clinical medicine, N.I. Pirogov Russian National Research Medical University (Pirogov University), Moscow, Russian Federation.E-mail: larinav@mail.ru
ORCID: https://orcid.org/0000-0001-7825-5597. eLibrary SPIN: 3674-9620
Ekaterina S. Shcherbina, MD, postgraduate student, assistant at the Department of outpatient therapy of the Institute of clinical medicine, N.I. Pirogov Russian National Research Medical University (Pirogov University), Moscow, Russian Federation.
E-mail: esscherbina@inbox.ru
ORCID: https://orcid.org/0000-0001-8619-8123. eLibrary SPIN: 6888-5050
Taisiya A. Matveychuk, MD, resident of the Department of outpatient therapy of the Institute of clinical medicine, N.I. Pirogov Russian National Research Medical University (Pirogov University), Moscow, Russian Federation.
ORCID: https://orcid.org/0009-0006-4764-3822
Similar Articles
