Adherence in heart failure in the elderly: problem and possible solutions

Int J Cardiol. 2008 Apr 10;125(2):203-8. doi: 10.1016/j.ijcard.2007.10.011. Epub 2007 Nov 26.

Abstract

Background: As a result of the improvement of pharmacological and non-pharmacological treatment of heart failure patients, the heart failure regimen is becoming more complicated, especially for elderly patients with co-morbid diseases. Non-adherence to this regimen is a problem in many heart failure patients, leading to worsening symptoms, rehospitalization and decreased quality of life.

Aim: This paper gives an overview of literature on adherence to pharmacological and non-pharmacological treatment in elderly heart failure patients. The paper addresses the definition of adherence and the extent and significance of the problem of non-adherence in elderly heart failure patients. Factors contributing to non-adherence, focused on the elderly are outlined and finally interventions to improve adherence in this elderly heart failure patient group are described.

Conclusion: Non-adherence to medication and lifestyle recommendations is a major problem in elderly heart failure patients. Five dimensions that affect adherence are described consisting of social and economic factors, factors related to the health care system, to the condition of the patient, the therapy and factors related to the patient. Since non-adherences is a multidimensional problem, interventions need to be directed to all factors that are related to adherence in elderly heart failure patients. A multidisciplinary approach in a heart failure team is crucial to improve adherence in this vulnerable patient group. Effectiveness of interventions to improve adherence in elderly heart failure patients needs to be further tested.

Publication types

  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cardiovascular Agents / economics
  • Cardiovascular Agents / therapeutic use
  • Delivery of Health Care / methods*
  • Heart Failure / economics
  • Heart Failure / psychology
  • Heart Failure / therapy*
  • Humans
  • Patient Compliance* / psychology
  • Risk Reduction Behavior
  • Socioeconomic Factors

Substances

  • Cardiovascular Agents