Noncompliance with self-care behavior and associated factors among adult patients with heart failure in Ethiopia: A systematic review and meta-analysis

Abstract Introduction: Heart failure is a major public health concern and a leading cause of death among adults and elderly individuals worldwide. In Ethiopia, more than one-third of heart failure patients die annually. Although several primary studies have been conducted to determine the prevalence of noncompliance with self-care behavior among adult patients with heart failure in Ethiopia, these studies have reported different findings. Consequently, this study aimed to determine the pooled prevalence of noncompliance with self-care behavior among patients with heart failure in Ethiopia. Methods: Searches were performed on the Google Scholar search engine, Scopus, PubMed, and Web of Science databases for relevant studies. A random-effects DerSimonian-Laird model was used to calculate the pooled prevalence of noncompliance with self-care behavior. Sensitivity and subgroup analyses were performed to control marked heterogeneity, and a funnel plot was used to assess publication bias. Results: A total of 17 primary studies with a sample size of 5,528 participants were included in the final meta-analysis. The pooled prevalence of noncompliance with self-care behavior among adult patients with heart failure was 59.70% (95% CI: 54.08, 65.32); I2 = 95.00%; P < 0.001). Comorbidities [AOR = 2.40, 95% CI: 1.88, 3.07]; depression [AOR = 2.70, 95% CI: 1.76, 4.14]; educational level (primary school or lower) [AOR = 1.72, 95% CI: 1.28, 2.30]; and poor social support [AOR = 2.77, 95% CI: 1.53, 5.03] were significantly associated with noncompliance with self-care behavior. Conclusions: The pooled prevalence of noncompliance with self-care behavior among heart failure patients was considerably high in Ethiopia. Comorbidities, depression, educational level (primary school or lower), and poor social support were the pooled independent predictors of noncompliance with self-care behavior in Ethiopia. Therefore, special attention should be given to patients with these identified risk factors. Moreover, healthcare providers should encourage heart failure patients to comply with all the recommended components of self-care behavior.