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Treatment Compliance

Compliance is a serious issue for HF patients. Getting them to adhere with sometimes difficult treatment plans can be a challenge. Lack of compliance is also a huge drain on the health care system. For example, one study showed that 64% of readmission cases at one hospital were due to non-compliance with prescribed medication or dietary plans [36]. Another showed that 53% of readmissions at one hospital could have been avoided if the patients had complied with their treatment [37].

Factors contributing to non-compliance:

  • Lack of knowledge

  • Poor motivation

  • Decreased understanding

  • Forgetfulness

  • Lack of support from family and friends

  • Lack of a daily reminder routine

  • Financial factors

  • Perception that side effects outweigh benefits

  • Poor outpatient education program

1.

Can you think of any ways in which health care providers contribute to non-compliance in heart failure patients?

Overall, there is little information available as to gender specific differences in compliance [15]. One study showed that women were more likely to adhere to Digoxin therapy than men were [38]

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15. Stromberg A, Martensson J. Gender differences in patients with heart failure. European Journal of Cardiovascular Nursing. 2003;2:7-18.

36. Ghali JK, Kadakia S, Cooper R, et al. Precipitating factors leading to decompensation of heart failre. Arch Intern Med. 1988;148:2013-2016.

37. Vinson JM, Rich MW, Sperry JC, et al. Early readmission of elderly patients with congestive heart failure. J Am Geriatr Soc. 1990;38:1290-1295.

38. Monane M, Bohn RL, Gurwitz JH, Glynn RJ, Avorn J. Noncompliance with congestive heart failure therapy in the elderly.Ar ch Intern Med 1994;154:433 –7.

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