Evidence map›Paper›PMID 41459384›Full record

ArticleInternational journal of cardiology. Cardiovascular risk and prevention2026

Assessment of prescriber adherence to guideline-directed medical therapy for heart failure at Jimma Medical Center, Ethiopia.

Getachew Yitayew Tarekegn, Legese Chelkeba, Mariam Dubale Deko, Fisseha Nigussie Dagnew, Samuel Berihun Dagnew, Tilaye Arega Moges, Sisay Sitotaw Anberbr, Taklo Simeneh Yazie, Addisu Assfaw Ayen, Behailu Terefe Tesfaye

Abstract read
In one paragraph

Article in International journal of cardiology. Cardiovascular risk and prevention, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Getachew Yitayew TarekegnDepartment of Pharmacy, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia.
Legese ChelkebaDepartment of Pharmacology and Clinical Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Mariam Dubale DekoSchool of Pharmacy, Department of Clinical Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia.
Fisseha Nigussie DagnewDepartment of Pharmacy, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia.
Samuel Berihun DagnewDepartment of Pharmacy, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia.
Tilaye Arega MogesDepartment of Pharmacy, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia.
Sisay Sitotaw AnberbrDepartment of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
Taklo Simeneh YazieDepartment of Pharmacy, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia.
Addisu Assfaw AyenDepartment of Internal Medicine, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
Behailu Terefe TesfayeSchool of Pharmacy, Department of Clinical Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Heart failure with reduced ejection fraction (HFrEF) requires guideline-directed medical therapy (GDMT) to reduce morbidity and mortality. However, adherence to GDMT is often suboptimal in resource-limited settings, such as the Jimma Medical Center, Ethiopia. Objectives: To assess prescriber adherence to guideline-based medical therapy in heart failure at Jimma Medical Center, Ethiopia. Methods: A convergent mixed-methods study was conducted from December 2023 to April 2024, enrolling 215 adult HFrEF patients. Prescriber adherence was measured using the Guideline Adherence Index (GAI) and QUALIFY scores. Semi-structured interviews with physicians explored the qualitative factors that affect adherence. Multinomial logistic regression identified the factors associated with adherence. Results: Only 13.5 % of patients were discharged on all four recommended GDMT classes (ACEI/ARB, beta-blockers, MRAs, and SGLT2 inhibitors). Moderate and poor prescriber adherence occurred in 70.1 % and 16.3 % of the cases, respectively. Patient adherence was higher (74.9 % by MARS-5), yet 94 % were physically inactive, and 54.4 % regularly consumed salt. Insurance coverage (AOR: 4.81; p = 0.001), salt restriction (AOR: 6.62; p = 0.003), and shorter hospital stays (AOR: 0.90; p = 0.005) were linked to better adherence, whereas higher ejection fraction (AOR: 1.07; p = 0.005) and more comorbidities (AOR: 2.36; p = 0.037) predicted poorer adherence. The qualitative findings highlighted medication stock-outs, financial barriers, and clinical complexities as key challenges, with institutional support and multidisciplinary care as facilitators. Conclusions: Prescriber and patient adherence to GDMT for HFrEF at Jimma Medical Center was suboptimal. Interventions targeting prescriber training, expansion of insurance coverage, patient education, and multidisciplinary care are needed to improve outcomes.

Indexed as

EthiopiaGDMTHeart failurePatient adherencePrescription adherenceReduced ejection fraction

Identifiers

PMID41459384
PMCPMC12743505

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.