Adherence to the therapy of patients with Heart Failure and Diabetes Mellitus: A Systematic Review

Abstract

A comorbidity like diabetes mellitus (DM) complicates heart failure (HF) self-care management and adherence to the therapy and results poorer clinical outcomes. This study aims to examine the various factors influencing adherence to the therapy of patients with HF and DM. A systematic literature search was established in the electronic data basis PubMed, Cochrane Library and Cumulative Index to Nursing and Allied Health Literature (CINAHL) using inclusion and exclusion criteria. The search yielded eight articles. The introduction of empowerment models in the management of patients with HF and DM made patients more involved in their self-care management and their self-monitoring behavior and adherence were increased. Patients with HF and DM during their hospitalization, were less likely to receive smoking cessation counseling and blood pressure control and experienced longer length of stay. Patients with HF preserved ejection fraction (HFpEF) and DM were less likely to receive an angiotensin convertive enzyme (ACE) inhibitor or angiotensin receptor or beta-blockers and had worse blood pressure (BP) control compared with patients with reduced ejection fraction (HFrEF) and DM. Effective self-care management of patients with HF and DM seems to depend on the type and the severity of comorbid conditions and the availability of effective therapies. Adequate support to patients with HF and DM from health professionals (HPs) is important, in order to establish self-management and adherence to the therapy.