Knowledge, Medication Adherence, Self-Care Behaviors, and Health Care Utilization Among Patients with Atrial Fibrillation: A Cross-Sectional Study

Background: Atrial fibrillation (AF) is a common cardiac arrhythmia associated with an increased risk of stroke, heart failure, and other adverse clinical outcomes. Self-care and treatment adherence are important components of preventing complications and improving long-term outcomes. This study aimed to assess AF-related knowledge, pharmacologic and nonpharmacologic treatment adherence, self-care behaviors, and health care utilization among patients attending the Atrial Fibrillation Clinic at Tehran Heart Center. Methods: This cross-sectional study was conducted between January and February 2024 among 144 patients randomly selected from the Atrial Fibrillation Clinic at Tehran Heart Center. Data were collected via telephone interviews using the Persian version of the Jessa Atrial Fibrillation Knowledge Questionnaire, a researcher-developed Atrial Fibrillation Self-Care Adherence Behavior Scale (AF-SCABS), and questions assessing health care utilization during the previous 6 months. Data were analyzed using descriptive statistics, t tests, analysis of variance, χ2 tests, and logistic regression analyses. Results: Participants had a mean age of 62.36 (11.40) years, and 56.2% were male. Fifty percent demonstrated moderate knowledge of AF, whereas 41.0% had poor knowledge. Only 20.8% demonstrated good pharmacologic treatment adherence. Poor adherence to nonpharmacologic treatment was observed in 45.8% of participants, and 52.1% reported poor overall self-care behaviors. During the previous 6 months, 42.4% had visited the emergency department, 21.6% had been hospitalized, and 13.9% reported hospital stays of 2 or more days. In multivariable analyses, knowledge, treatment adherence, and self-care were not independently associated with emergency department visits or hospital admissions. Conclusion: Patients with AF demonstrated limited disease-related knowledge, suboptimal treatment adherence, and poor self-care behaviors, highlighting the need for context-specific educational and behavioral interventions to support effective self-management.