Adherence to treatment as an integral component of the management of patients with heart failure

Abstract

The problem of rational management of patients with heart failure (HF) remains extremely relevant due to its increasing incidence and poor prognosis. Based on current guidelines, therapy for patients with HF involves systematic and long-term use of many medications, and their effectiveness largely depends on the quality of the patient’s compliance. Pharmacotherapy of older patients with HF is complicated by metabolism and the coexistence of many diseases associated with polypharmacy, which significantly reduces the response to therapy. Insufficient adherence to treatment has been proven to reduce the quality of life of patients. Currently, three HF phenotypes have been identified, depending on the left ventricular ejection fraction. However, the number of studies examining the characteristics of patient adherence in different phenotypes is limited, which requires further research. The article is an analytical review devoted to various aspects of adherence to treatment in patients with HF. The terms and concepts associated with compliance, the history of its research, the main modern approaches to pharmacotherapy of HF for different phenotypes are briefly covered. The results of a number of large clinical studies are presented, including the assessment of adherence in patients with HF and its relationship with prognosis.