title: Compliance in heart failure patients: the importance of knowledge and beliefs.
abstract: OBJECTIVE
  Non-compliance in patients with heart failure (HF) contributes to worsening HF symptoms and may lead to hospitalization. Several smaller studies have examined compliance in HF, but all were limited as they only studied either the individual components of compliance and its related factors or several aspects of compliance without studying the related factors. The aims of this study were to examine all dimensions of compliance and its related factors in one HF population.
  
  
  RESULTS
  Data were collected in a cohort of 501 HF patients. Clinical and demographic data were assessed and patients completed questionnaires on compliance, beliefs, knowledge, and self-care behaviour. Overall compliance was 72% in this older HF population. Compliance with medication and appointment keeping was high (>90%). In contrast, compliance with diet (83%), fluid restriction (73%), exercise (39%), and weighing (35%) was markedly lower. Compliance was related to knowledge (OR=5.67; CI 2.87-11.19), beliefs (OR=1.78; CI 1.18-2.69), and depressive symptoms (OR=0.53; CI 0.35-0.78).
  
  
  CONCLUSIONS
  Although some aspects of compliance had an acceptable level, compliance with weighing and exercise were low. In order to improve compliance, an increase of knowledge and a change of patient's beliefs by education and counselling are recommended. Extra attention should be paid to patients with depressive symptoms.
authors.affiliation: Department of Cardiology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. m.h.l.van.der.wal@thorax.umcg.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: Debra K
authors.initials: DK
authors.lastname: Moser
authors.forename: Nic J G M
authors.initials: NJ
authors.lastname: Veeger
authors.forename: Wiek H
authors.initials: WH
authors.lastname: van Gilst
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: van Veldhuisen
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008297:Male; D010349:Patient Compliance; D012044:Regression Analysis; D012307:Risk Factors; D011795:Surveys and Questionnaires