Advances in Heart Failure Interventions to Enhance Adherence to Medications in Patients With Heart Failure A Systematic Review

Prognosis remains poor for patients with chronic heartfailure (CHF), despite improvements in the prevention and treatment of heart failure over the last 25 years. Recent estimates indicate that the median survival after a first episode of heart failure is 2.3 years for men and 1.8 years for women.1 It is suggested that the improvements in outcomes that have been achieved can be partly explained by increases in prescribing rates of medications such as angiotensin-converting enzyme inhibitors,2 -blockers,3 and spironolac-tone4 over this period.1 Although the evidence on medication efficacy for certain subgroups of patients with CHF is clear, there are also compelling data showing that many of these patients do not take their medications as prescribed by health care providers.5,6 This “nonadherence ” to medication there-fore remains a significant barrier to enhancing the effective-ness of existing treatments