Improving Treatment Adherence in Heart Failure.
Background: Despite improved treatment options, heart failure remains the third most common cause of death in Germany and the most common reason for hospitalization. The treatment recommendations contained in the relevant guidelines have been incompletely applied in practice. The goal of this system...
| Publicado en: | Deutsches Ärzteblatt International Vol. 113; no. 25; pp. 423 - 476 |
|---|---|
| Autores principales: | , , , , , |
| Formato: | Journal Article |
| Publicado: |
Deutscher Aerzte-Verlag GmbH
6/24/2016
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=116783022&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 116783022 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18660452 5F0N jtl: Deutsches Ärzteblatt International issn: 18660452 maglogo: N pubinfo: dt: 6/24/2016 vid: 113 iid: 25 pid: 25312 pub: Deutscher Aerzte-Verlag GmbH artinfo: ui: 116783022 10.3238/arztebl.2016.0423 116783022 ppf: 423 ppct: 53 formats: fmt: @attributes: type: P tig: atl: Improving Treatment Adherence in Heart Failure. aug: au: Unverzagt, Susanne Meyer, Gabriele Mittmann, Susanne Samos, Franziska-Antonia Unverzagt, Malte Prondzinsky, Roland affil: Institute for Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale) sug: ab: Background: Despite improved treatment options, heart failure remains the third most common cause of death in Germany and the most common reason for hospitalization. The treatment recommendations contained in the relevant guidelines have been incompletely applied in practice. The goal of this systematic review is to study the efficacy of adherence-promoting interventions for patients with heart failure with respect to the taking of medications, the implementation of recommended lifestyle changes, and the improvement in clinical endpoints. Methods: We performed a meta-analysis of pertinent publications retrieved by a systematic literature search. Results: 55 randomized controlled trials were identified, in which a wide variety of interventions were carried out on heterogeneous patient groups with varying definitions of adherence. These trials included a total of 15 016 patients with heart failure who were cared for as either inpatients or outpatients. The efficacy of interventions to promote adherence to drug treatment was studied in 24 trials; these trials documented improved adherence in 10% of the patients overall (95% confidence interval [CI]: [5; 15]). The efficacy of interventions to promote adherence to lifestyle recommendations was studied in 42 trials; improved adherence was found in 31 trials. Improved adherence to at least one recommendation yielded a long-term absolute reduction in mortality of 2% (95% CI: [0; 4]) and a 10% reduction in the likelihood of hospitalization within 12 months of the start of the intervention (95% CI: [3; 17]). Conclusion: Many effective interventions are available that can lead to sustained improvement in patient adherence and in clinical endpoints. Long-term success depends on patients' assuming responsibility for their own health and can be achieved with the aid of coordinated measures such as patient education and regular follow-up contacts. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|