title: Perceived medication adverse effects and coping strategies reported by chronic heart failure patients.
abstract: BACKGROUND
  Data on medication adverse effects (AEs) in chronic heart failure (CHF) are primarily based on results from clinical trials. Little is known about AEs perceived by CHF patients in daily practice and how patients deal with these subjective AEs.
  
  
  OBJECTIVE
  To describe the scope and nature of perceived AEs of CHF patients, their coping strategies and the relationship of perceived AEs to medication, patient characteristics and quality of life.
  
  
  METHODS
  This cross-sectional observational study included a sample of 680 patients previously hospitalised for CHF. Perceived AEs and coping strategies were collected by interviews based on a structured questionnaire. Medication and clinical information were collected by chart review.
  
  
  RESULTS
  Of the 670 CHF patients completing the questionnaire, 17% reported at least one AE. In total, 186 AEs were reported of which 15% could not be linked to any medication. Nausea (4%), dizziness (4%), itches (3%) and rash (3%) were the most prevalent. The drug associated with the highest AE rate was pravastatin (27%). On average, more than five different drugs could be related to the AEs headache, dizziness and nausea. Patients reporting AEs had a lower general health perception, younger age and were more often using antiarrhythmic drugs. Of patients experiencing AEs, 69% conferred with their doctor, 24% reported having done nothing in reaction and 2% discontinued their medication without discussing it with the doctor.
  
  
  CONCLUSIONS
  Adverse effects are frequently perceived by CHF patients, but they are difficult to recognise and manage in daily practice.
authors.affiliation: Department of Clinical Pharmacology, University Medical Center Groningen, University of Groningen, The Netherlands. r.h.e.de.smedt@med.umcg.nl
authors.forename: R H E
authors.initials: RH
authors.lastname: De Smedt
authors.forename: P
authors.initials: P
authors.lastname: Denig
authors.forename: F M
authors.initials: FM
authors.lastname: Haaijer-Ruskamp
authors.forename: T
authors.initials: T
authors.lastname: Jaarsma
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D001294:Attitude to Health; D002317:Cardiovascular Agents / Q000009:adverse effects*; D002908:Chronic Disease; D003376:Counseling; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects; D006333:Heart Failure / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D010465:Perception
chemical_list: D002317:Cardiovascular Agents; D005343:Fibrinolytic Agents