Health Related Quality of Life and Its Determinants in Heart Failure with Reduced Ejection Fraction Patients after Optimal Guideline Directed Medical Therapy at St. Paul’s Hospital, Ethiopia, 2025 G.C.

Abstract

ABSTRACT Introduction: Heart failure is a pandemic disease with an estimated 64.3 million people suffering worldwide. It is associated with frequent hospitalization and significant mortality. Living with heart failure is not only having a weak heart rather living with a life time fear of hospital admission and loosing life. Many Randomized clinical trial treat Health related quality of life as a secondary or exploratory endpoint. Real-world data on Health related quality of life outcomes in cardiac clinic populations receiving Guideline directed medical therapy in low income countries Ethiopia in particular are scarce. Objective: This study aims to assess health related quality of life and its determinants in HFrEF after optimal GDMT at St. Paul’s Hospital, Ethiopia, 2025.GC Methods: Institutional based cross-sectional study was conducted at St. Paul’s Millennium Medical College. To detect the best determinants of health related poor quality of life, the sample size of 188 patients were selected using a random sampling technique and data was collected using structured questionnaire. The collected data was entered and analyzed using SPSS version 28. In order to determine the association between dependent variable and the independent variables, a binary logistic regression model was conducted. The significant variables from the bivariate tests will be included in multivariable logistic regression to identify the determinants of poor health related quality of life. All variables with p-value of less than 0.05 are considered to be significant. Results: A total of 188 patients with HFrEF on optimal GDMT were included. Poor HRQoL was observed in 95 (50.5%) participants, while 38 (20.2%) had good HRQoL. In multivariable analysis, age, NYHA functional class, comorbidity, duration of GDMT, social support, and medication adherence were significantly associated with poor HRQoL. Patients in NYHA class III and IV and those with comorbidities had significantly higher odds of poor HRQoL. Poor and moderate medication adherence were also associated with increased odds, while moderate social support and shorter GDMT duration were associated with reduced odds. Conclusion: Poor HRQoL remains highly prevalent among patients with HFrEF despite optimal GDMT. Clinical severity, comorbidity, medication adherence, and social support were key factors Keywords: Heart failure, Health-related quality of life, Guideline-directed medical therapy