Adherence to the medical regime in patients with heart failure

• Published in: European journal of heart failure Vol. 12; no. 4; pp. 389 - 396
• Main Authors: Muzzarelli, Stefano, Brunner-La Rocca, Hanspeter, Pfister, Otmar, Foglia, Pietro, Moschovitis, Giorgio, Mombelli, Giorgio, Stricker, Hans
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.04.2010
• Subjects: Adherence to the medical regime; Aged; Cardiotonic Agents - blood; Cardiotonic Agents - therapeutic use; Digoxin - blood; Digoxin - therapeutic use; Female; Health Behavior; Heart failure; Heart Failure - drug therapy; Humans; Male; Medication Adherence; Pilot Projects; Prospective Studies; Psychometrics; Risk Factors; Surveys and Questionnaires; Switzerland; Switzerland
• ISSN: 1388-9842; 1879-0844
• DOI: 10.1093/eurjhf/hfq015

Aims To assess adherence to medical treatment in patients with heart failure (HF) using a specific questionnaire and measurement of the serum concentration of digoxin. Methods and results Forty patients with symptomatic HF and a clinical indication for digoxin were included in this pilot study. The assessment of adherence to the medical regime was based on two different methods: (i) the CARDIA‐Questionnaire and (ii) the measurement of serum digoxin concentration (SDC) at 1 and 6 months. All patients were placed on digoxin treatment (target SDC 0.6–0.8 ng/mL) at baseline. Poor adherence was defined if the patient self‐reported taking ≤75% of the prescribed HF medication or had an SDC < 0.4 ng/mL (subtherapeutic range) at the follow‐up visits. During the entire follow‐up, the proportion of patients with poor adherence was 15% as assessed by the questionnaire, 20% as assessed by the SDC, and 25% if both methods were combined. Conclusion Although HF is a symptomatic disease, the proportion of patients with poor adherence to the medical regime in our study was high (up to 25%). The objective methodology based on the measurement of the SDC identified a higher number of patients with poor adherence when compared with the CARDIA‐Questionnaire.