The Impact of Self-efficacy and Health Literacy on Medication Adherence and Health-related Quality of Life in Patients with Heart Failure: A Systematic Review

Context: Effective implementation of self-care programs can reduce the treatment costs and the risk of severe complications of heart failure (HF). However, people with low health literacy (HL) fail to properly conduct the complex care techniques. The control of chronic, progressive, and complex diseases largely depends on self-efficacy, adherence to treatment, and health-related quality of life (HRQoL). The purpose of this systematic review is to study research literature to explore the impact of self-efficacy and HL on medication adherence and HRQoL in patients with HF. Evidence Acquisition: Considering the PRISMA guideline, this systematic review study the articles published between 1999 and 2022. The articles written in the English language were recruited from PubMed, Scopus and Web of Science, CINAHL Plus, Embase, Cochrane, PsycINFO and google scholar databases. The quality of the studies was assessed by the organization Agency for Healthcare Research and Quality (AHRQ) and then the data was collected based on the designed checklists. Results: A total of 27 articles met the inclusion and exclusion criteria. The studies were conducted on range of 44 to 705 patients with HF. Inadequate HL was observed to have a high prevalence in HF patients. Health literacy had a direct impact on quality of life and treatment adherence in all studies. Several studies have shown that interventions to increase patient self-efficacy led to greater adherence to treatment, higher quality of life, and lower hospitalization rates in the HF population. Low self-efficacy in patients was linked to high rates of comorbidity. Conclusions: Self-efficacy and HL have a positive effect on the quality of life, adherence to treatment, and reduction of mortality in patients with HF. Therefore, the implementation of training programs to improve these areas should be formulated by the health systems.