Heart Patients Take Their Meds, But Won't Exercise

Older patients with heart failure are more likely to take their medications as directed and to keep their office appointments, but they are less likely to follow advice to exercise and to check their weight regularly, according to a new study. Depression, the authors suggest, may contribute to the patients' lack of compliance.

Non-compliance with heart failure medication and diet recommendations contributes to worsening symptoms, leading to hospitalization in many instances. To pinpoint patient-related factors that influence compliance with heart failure regimens, Dr. Martje H. L. van der Wal from University Medical Center Groningen, the Netherlands, and colleagues surveyed 501 older heart failure patients.

Overall, 72 percent of the patients were compliant with their heart failure regimen, the team reports in the European Heart Journal. Compliance with medication and office appointments was "surprisingly high," more than 90 percent, they note. However, compliance with salt and fluid restriction was markedly lower, at 79 percent and 73 percent, respectively. More than 25 percent of patients said they were thirsty because of the fluid restriction and 13 percent found the sodium restriction not palatable.

The lowest compliance rates were for exercise and weighing, with only 39 percent of the subjects complying with exercise advice and only 35 percent getting on the scale daily or at least three times per week.

According to van der Wal's group, a lack of knowledge about heart failure and its treatment seems to be a "serious problem." For example, 14 percent of patients reported that they did not know that it was important to weigh themselves regularly, 30 percent did not know they should restrict fluids, and 28 percent thought they had to drink more fluids in case of thirst.

"It is a major challenge for healthcare providers to improve knowledge of heart failure patients on these subjects," the authors conclude.

Because patients with more depressive symptoms showed more non-compliant behavior in this study, the researchers suggest that "extra attention" should be paid to this patient subgroup.

This article is reprinted from the European Heart Journal.