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Adherence, is it all up to the patient?

Published:September 02, 2022DOI:https://doi.org/10.1016/j.hrtlng.2022.08.009
      I was excited to see the recent publication of the 2022 ACC/AHA/HFSA Guideline for the Management of Heart Failure, which continues to define, refine and improve care to our very complex patients. The specified intent of these guidelines to “provide patient-centric recommendations for clinicians to prevent, diagnose and manage patients with heart failure and to improve quality of care and align with patients’ interests”
      • Heidenreich P.A.
      • Bozkurt B.
      • Aguilar D.
      • et al.
      2022 ACC/AHA/HFSA guideline for the management of heart failure: executive summary.
      is timely and recognizes the important role of patient individuality in response to therapy and their willingness to engage in the plan. I found the “4 medication pillars” format on GDMT especially helpful and simplified for clinicians, however in the context of patients, 4 categories of medications for HF, in addition to many other medications for co-morbid conditions doesn't sound so simple.
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      References

        • Heidenreich P.A.
        • Bozkurt B.
        • Aguilar D.
        • et al.
        2022 ACC/AHA/HFSA guideline for the management of heart failure: executive summary.
        J Cardiac Failure. 2022; 28: 810-830
      1. Ross MS. Key differences between treatment adherence vs compliance [Blog post]; 2019. Retrieved from http://www.cureatr.com/key-difference-between-treatment-adherence-vs-compliance.

      2. Sabate E, ed. Adherence to Long Term Therapies: Evidence for Action. Geneva, Switzerland: World Health Organization: 2003.

      Biography

      Linda Ordway, RN, MS, ACNP-BC, CHFN, has been a heart failure nurse for 25 years. She is an Acute Care Nurse Practitioner in Advanced Heart Failure, VAD and Transplant at Tufts Medical Center, Boston MA. Linda has been involved with AAHFN since 2011 and a Certified Heart Failure Nurse since 2012. Her focus is inpatient care of advanced heart failure patients including invasive hemodynamic monitoring, development of novel environments of care/staffing models, mechanical circulatory support and palliative/end of life care in the VAD population.