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.
