title: Unraveling the mechanisms for heart failure patients' beliefs about compliance.
abstract: BACKGROUND
  Compliance with medication, diet, and monitoring symptoms is a problem in heart failure (HF) patients. Noncompliance can lead to worsening symptoms and is associated with personal beliefs about compliance. To intervene effectively, knowledge of factors related to patients' beliefs about compliance is needed.
  
  
  OBJECTIVE
  The aims of this study are to: (1) gain insight into patients' beliefs about compliance; (2) examine the association of demographic variables and depressive symptoms to beliefs; (3) assess compliance with medication, diet, and daily weighing; and (4) examine the association of compliance to patients' beliefs.
  
  
  METHODS
  Nine hundred fifty-four HF patients completed questionnaires on beliefs about medication and diet; 297 patients also completed a questionnaire on beliefs about symptom monitoring. Most important barriers and benefits were assessed as well as differences in beliefs between subgroups and the association between compliance and beliefs.
  
  
  RESULTS
  The most important barriers were diuresis during the night (57%), the taste of food (51%), and limited ability to go out (33%). A barrier related to failure to weigh daily was forgetfulness (26%). Patients with depressive symptoms and patients with a low level of HF knowledge experienced more barriers to compliance with the HF regimen. Self-reported compliance with medication was almost 99%, compliance with diet 77%, and with daily weighing 33%.
  
  
  CONCLUSIONS
  In order to improve compliance, it is important that interventions should be directed to those patients who experience more barriers to compliance, such as patients with depressive symptoms and patients with a low level of knowledge on the HF regimen. Improvement of knowledge, therefore, will remain an important issue in HF management programs.
authors.affiliation: Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
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: Wiek H
authors.initials: WH
authors.lastname: van Gilst
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: van Veldhuisen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D006333:Heart Failure / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D010817:Physician-Patient Relations; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014342:Truth Disclosure