Angiotensin converting enzyme inhibitors’ utilization, dose optimization and associated factors among chronic heart failure patients at Felege Hiwot Comprehensive Specialized Hospital Northwest Ethiopia, 2020.

Abstract

Abstract Introduction-: Utilization and dose optimization of angiotensin-converting enzyme inhibitors (ACEI) are important for improving the treatment outcome in heart failure (HF) patients with reduced ejection fraction. However, little was known about dose optimization and proper utilization of ACEI, Objectives: This study was aimed to assess the utilization, dose optimization, and associated factors of ACEI among HF patients at Felege Hiwot Comprehensive Specialized Hospital (FHCSH), North-west Ethiopia, 2020. Methods: A retrospective follow up study was conducted on 372 study participants. From May 20 to August 30, 2020, at ambulatory care clinic in FHCSH. A systematic random sampling method was implemented to select study participants. Data were collected from the patient interview and review of medical records. EpiData and SPSS version 21 was used for data entry and analysis. The bivariable logistic regression analysis was done to determine the association of each independent variable with the utilization and dose optimization of ACEIs. Results: A total of 372 study participants were included in this study from May 20 to August 30, 2020. Out of the total, 68.8% of the participants ACEIs, only 30.6% were taking the optimal dose. Valvular heart disease (AOR):0.056, 95%CI; 0.107-0.465), hypertension (AOR: 6.97, 95%CI; 3.23-15.02) diabetes mellitus (AOR: 6.16CI (2.22-17.35), ischemic heart diseases (AOR: 4.86CI (3.40-20.94) and chronic kidney diseases (AOR: 3.59 CI :( 2.11-17.34) were significantly associated with the ACEIs utilization. Age ?65years (AOR 5.04CI (2.81-12.56) and a dose of furosemide ?40mg (AOR, 2.62CI (1.28-16.74) were significantly associated with of suboptimal dosing of ACEIs. Conclusion: Even though the majority of HF patients were receiving ACEIs, only one-third of patients were using the optimal dose of this drugs. The presence of chronic disease comorbidity and older in age were significantly associated with the utilization of ACEIs. Older in age and dose of furosemide greater ?40mg were positively associated with the suboptimal dosing of ACEIs. Thus, more attention needs to be given for older heart failure patients to optimize the dose of ACEIs given. Keywords: Angiotensin-converting enzyme inhibitors, utilization, dose optimization, Heart Failure, Bahir Dar, Ethiopia.