Heart failure medication adherence

The clinician must identify potential reversible causes of heart failure exacerbations including prescription and nonprescription drug therapies, dietary indiscretions, and medication non-adherence. 

Abraham WT, Adams KF, Fonarow GC, et al. In-hospital mortality in patients with acute decompensated heart failure requiring intravenous vasoactive medications an analysis from the Acute Decompensated Heart Failure National Registry (ADHERE). J Am Coll Cardiol. 2005 46 57-64. 

Pharmacists can play an important role in the multidisciplinary team management of heart failure. Compared with conventional treatment, pharmacist intervention that included medication evaluation and therapeutic recommendations, patient education, and follow-up telephone monitoring reduced hospitalizations for heart failure. Adherence to guideline-recommended therapy was improved by pharmacist intervention. Thus the role and cost benefits of pharmacist involvement in the multidisciplinary care of heart failure... 

Because hypertension is usually a silent disease, most patients do not experience symptoms that remind them of the need for taking medications. Without symptoms, it is more difficult to establish a link in the patient s mind between taking the medication and controlling hypertension and its complications. Because patients often do not feel or perceive the benefits of their treatment, the first step in enhancing adherence is to educate them about hypertension and its serious complications, such as coronary heart disease, stroke, and renal failure. 

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