Adherence to Guideline-Directed Medical Treatments in Heart Failure. A Scientific Statement of the Heart Failure Association (HFA) of the ESC and the ESC Working Group on Cardiovascular Pharmacotherapy
Gianluigi Savarese, Felix Lindberg, Antonio Cannatà, Marianna Adamo, Giuseppe Ambrosio, Pietro Ameri, Markus S. Anker, Magnus Bäck, Antoni Bayés‐Genís, Tuvia Ben Gal, Frieder Braunschweig, Ovidiu Chioncel, Emilia D’Elia, Hassan El‐Tamimi, Gerasimos Filippatos, Nicolas Girerd, Loreena Hill, Ewa A. Jankowska, Kamlesh Khunti, Basil S. Lewis, Brenda Moura, Offer Amir, Stefania Paolillo, Massimo Piepoli, Abdulla Shehab, Maggie Simpson, Hadi Skouri, Davide Stolfo, Carlo G. Tocchetti, Cristiana Vitale, Maurizio Volterrani, Stephan von Haehling, Sven Waßmann, Mehmet Birhan Yılmaz, Juan Carlos Kaski, Dobromir Dobrev, Marco Metra, Giuseppe M.C. Rosano
Abstract
Heart failure (HF) affects over 60 million individuals globally. Contemporary guideline-directed medical therapies (GDMT) reduce cardiovascular mortality and HF hospitalizations. However, medication non-adherence represents a critical barrier limiting real-world efficacy of GDMT. This scientific statement aims to provide a comprehensive framework for understanding, measuring, and addressing medication non-adherence in HF management across diverse healthcare settings. Addressing medication non-adherence requires systematic, multifaceted approaches targeting individual patient barriers while implementing system-level interventions. Polypills, digital monitoring platforms, enhanced patient education and empowerment, and multidisciplinary care models represent promising strategies to optimize therapeutic adherence and improve clinical outcomes in HF management.