Background: Chronic heart failure is a complex clinical syndrome with typical symptoms that can occur at rest or on effort. It requires patients to manage their lifestyle with their disease and when to notify their provider. The study aimed to identify Medication adherence and associated factors among chronic heart failure clients on follow up Oromia region, West Ethiopia, 2017.

Methods: Institutional based cross-sectional study design was employed, after selecting three hospitals by lottery method and allocating respondents to the three hospitals proportionally. A total of 424 patients admitted to the medical ward and/or chronic follow up of Nekemte referral, Gimbi, and Shambu hospitals. The data was collected using a structured questionnaire. The data was entered, into Epi-data version 3.1, cleared, explored, and then exported to SPSS windows version 24.0 for further analysis. Variable having a p-value less than 0.05 in the bivariate analysis was a candidate for multivariable analysis and effect of confounding variables was looked. Variables having a p-value less than 0.05 in the multivariable analysis was taken as having significant.

Result: A total of 424 respondents were included in the final analysis giving a 95.3% response rate. The result indicated that more than half of the study participants have adhered to prescribed medication. Respondents with good self-care behavior were more likely to adhere medication at [AOR (95% CI of OR) = 2.744(1.29, 3.52)]. Respondents those limited fluid intake to one or half-liter are more likely to adhere to the medication at [AOR (95% CI of OR) = 2.5(1.43, 4.49)]. It was also found that those avoided spice sauces and others from food are 2.2 more likely to adhere to the medication at [AOR (95% CI of OR) = 2.2 (1.152, 4.039)].

Conclusion and recommendation: Even if more than half of the study respondents have, good medication and self-care adherence still it needs great attention in health education over on their visit. We recommend health institution strongly to give health education for clients and researcher to use advanced study design for measuring medication adherence and self-care behaviors.

Keywords: Chronic heart failure, Medication adherence, Self- care behavior.