title: Non-compliance in patients with heart failure; how can we manage it?
abstract: BACKGROUND
  Because of the improvement of the pharmacological and non-pharmacological treatment in heart failure (HF) patients, the HF related therapeutic regimen is becoming more complicated. Non-compliance with this regimen can result in worsening HF symptoms, sometimes leading to hospitalisation.
  
  
  OBJECTIVE
  The aims of this systematic literature review are (1) to describe the consequences of non-compliance in HF patients; (2) to summarise the degree of compliance in the various aspects of the therapeutic regimen; and (3) to review interventions that are recommended to improve compliance in HF patients.
  
  
  METHODS
  A literature search of the MEDLINE and CINAHL database from 1988 to June 2003 was performed. Studies on compliance with life style recommendations according to the HF Guidelines of the European Society of Cardiology and the American Heart Association/American College of Cardiology were included.
  
  
  CONCLUSIONS
  Non-compliance with medication and other lifestyle recommendations is a major problem in patients with HF. Evidence based interventions to improve compliance in patients with HF are scarce. Interventions that can increase compliance and prevent HF related readmissions in order to improve the quality of life of patients with HF need to be developed and tested.
authors.affiliation: Department of Cardiology, University Hospital Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands. m.h.l.van.der.wal@thorax.azg.nl
authors.forename: Martje H L
authors.initials: MH
authors.lastname: van der Wal
authors.forename: Tiny
authors.initials: T
authors.lastname: Jaarsma
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: van Veldhuisen
mesh_terms: D000328:Adult; D037001:Directive Counseling; D005247:Feeding Behavior; D006333:Heart Failure / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D008019:Life Style; D010353:Patient Education as Topic; D040242:Risk Reduction Behavior; D016312:Treatment Refusal