Chronic heart failure and adherence to medication: methods for assessing adherence to therapy and unresolved issues

The review of the literature examines the General problems of treatment of chronic heart failure, among which special attention is paid to the problem of adherence. This problem remains one of the most urgent and difficult to solve in medicine, because it directly affects the effectiveness of treatment and the outcome of the disease. The article considers the commitment of both doctors to comply with clinical recommendations and patients to prescribed therapy. Some of the reasons that explain the lack of adherence to treatment (such as gender, age, institution where the patient is observed, and others) are described. It is also described that comorbidity is an aggravating factor in the treatment of chronic heart failure. It is described that comorbidity is an aggravating factor in the treatment of chronic heart failure. The presence of concomitant diseases increases the number of medications taken, which exacerbates the problem of adherence to medication therapy. It is noted that medical registry is the ideal model for studying adherence in clinical practice. The main Russian registers included of patients with chronic heart failure are considered. It is noted that in none of them a full assessment of patients’ adherence to therapy was carried out. In the largest foreign chronic heart failure registers, the assessment of commitment is also given insufficient attention. Separate clinical trials are described, including randomized trials, specifically studying various aspects of the problem of adherence and its impact on the course of the disease. Special attention is paid to the methods of assessing adherence in these studies. It is noted that there is no “gold standard” for its evaluation, and existing methods (such as Chips, determining the concentration of the drug in the blood, counting prescription forms and others) are unacceptable for real clinical practice. This indicates the need and prospects for further work on assessing adherence to therapy in patients with chronic heart failure.

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Diary of self-monitoring of the patient as a way to increase adherence to the treatment of patients with chronic heart failure

Russian Family Doctor ◽

10.17816/rfd2019221-26 ◽

2019 ◽

Vol 23 (2) ◽

pp. 21-26

Author(s):

Elena V. Frolova ◽

Alena I. Ogorelysheva ◽

Ekaterina S. Spasenova ◽

Tamara R. Khalilova

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Self Control ◽

Control Group ◽

Adherence To Treatment ◽

Self Monitoring ◽

Phone Calls ◽

Sequential Sample ◽

Adherence To Therapy

Chronic heart failure (CHF) is the most frequent and severe complication of cardiovascular disease (CVD). One of the most important aspects of management of patients with CHF remains to ensure adherence to treatment. The purpose of the study was to assess the effectiveness of therapy of patients with CHF with the use of a diary of self-control as a way of enhancing adherence to therapy. Materials and methods. A continuous sequential sample was used to select 40 patients with diagnosed Heart Failure II-IV FC (NYHA), who were then randomized into two groups: the follow-up group (n = 20) and the control group (n = 20). The study duration was 8 weeks. Patients of the observation group received materials on self-control (“Diary of a patient with heart failure”). For them, 3 control visits and 8 phone calls were organized once a week. The participants of the control group were observed in the usual conditions of practical health care; 3 control visits to the doctor were provided for them. The results obtained at week 8 of the study showed that the number of complaints of foot and Shin edema decreased by 2 times compared to the initial data; in the control group, the frequency of complaints did not have a positive dynamic. Conclusion. Use of a diary of self-control is the easiest method of improving adherence of patients with CHF to treatment.

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Short-Term Change in Distance Walked in 6 Min Is an Indicator of Outcome in Patients With Chronic Heart Failure in Clinical Practice

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2006.02.061 ◽

2006 ◽

Vol 48 (1) ◽

pp. 99-105 ◽

Cited By ~ 50

Author(s):

Andrea Passantino ◽

Rocco Lagioia ◽

Filippo Mastropasqua ◽

Domenico Scrutinio

Keyword(s):

Heart Failure ◽

Clinical Practice ◽

Chronic Heart Failure ◽

Short Term ◽

Short Term Change ◽

Term Change

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SUPPORTING DEVICES IN THE TREATMENT OF CHRONIC HEART FAILURE IN ELDERLY AND OLD PATIENTS

Pharmacy Formulas ◽

10.17816/phf41944 ◽

2020 ◽

Vol 2 (3) ◽

pp. 40-57

Author(s):

Gennadiy Hubulava ◽

Kirill L. Kozlov ◽

Andrey N. Bogomolov ◽

Aleksey Volkov ◽

Viktor N. Fedorets ◽

...

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Clinical Practice ◽

Chronic Heart Failure ◽

Severe Heart Failure ◽

Circulatory Support ◽

Old Patients ◽

Western Countries ◽

Surgical Methods

Chronic heart failure (CHF) is a widespread disease associated with high rates of disability and mortality, as well as a decrease in the quality of life. Moreover, the vast majority of patients are elderly and senile. Modern surgical methods of treating heart failure are able to increase the duration and quality of life of such patients, however, the need far exceeds the volume of this care, and some highly effective methods common in Western countries are still not used in Russian clinical practice. Elderly age is a risk factor for the development of senile asthenia (frailty) and concomitant pathology. Large abdominal surgery is often contraindicated for patients with signs of senile asthenia, and the method of choice in patients with severe heart failure is the implantation of devices for long-term mechanical circulatory support (LT-MCS). After implantation of LT-MCS, a regression of signs of senile asthenia may be observed. The topic of an integrated approach to non-drug treatment of heart failure in elderly and senile patients in Russia has not been studied enough. In particular, the implantation of LT-MCS is not used in Russian clinical practice, while in many Western countries for many years it has been the main and most effective treatment for severe heart failure. Systematization of the available up-to-date information on this topic could help increase the duration and quality of life of patients with severe heart failure.

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