In Europe an estimated 10 million patients are affected by heart failure, and in the USA chronic heart failure (CHF) accounts for more that 1 million hospital admissions. Numerous studies have found that adherence to medication and lifestyle modifications can reduce mortality in CHF but adherence to these interventions are often below optimum.
In the CHARM trial Bradi Granger (Duke University Health System, Durham, North Carolina, USA) and colleagues compared the effects of the drug candesartan with placebo in nearly 7600 patients with chronic heart failure. They followed up patients for 3 years and classified people as good or bad adherers depending on the length of time that they took more or less than 80% of their study medication. They found good adherence was associated with lower all-cause mortality in all patients, even those on placebo.
Dr Granger states: "Good adherence to medication is associated with a lower risk of death than poor adherence in patients with CHF, irrespective of assigned treatment. This finding suggests that adherence is a marker for adherence to effective treatments other than study medications, or to other behaviours that affect outcome."
See also accompanying comment.
Contact: Dr Bradi B Granger PhD, 8020 Willardville Station Road, Bahama NC 27503, USA. T) 919-620-0320, grang004@mc.duke.edu
The Lancet