Adherence to Guideline-Directed Medical Treatments in Heart Failure. A Scientific Statement of the Heart Failure Association (HFA) of the ESC and the ESC Working Group on Cardiovascular Pharmacotherapy
Heart failure (HF) affects over 60 million individuals globally. Contemporary guideline-directed medical therapies (GDMT) reduce cardiovascular mortality and HF hospitalizations. However, medication non-adherence represents a critical barrier limiting real-world efficacy of GDMT. This scientific statement aims to provide a comprehensive framework for understanding, measuring, and addressing medication non-adherence in HF management across diverse healthcare settings. Addressing medication non-adherence requires systematic, multifaceted approaches targeting individual patient barriers while implementing system-level interventions. Polypills, digital monitoring platforms, enhanced patient education and empowerment, and multidisciplinary care models represent promising strategies to optimize therapeutic adherence and improve clinical outcomes in HF management.
Authors
- Maggie Simpson (ORCID: https://orcid.org/0000-0003-1781-4978)
- Markus S. Anker (ORCID: https://orcid.org/0000-0002-4406-8555)
- Nicolas Girerd (ORCID: https://orcid.org/0000-0002-3278-2057)
- Gianluigi Savarese (ORCID: https://orcid.org/0000-0001-7732-0887)
- Antoni Bayes-genis A (ORCID: https://orcid.org/0000-0002-3044-197X)
- Gerasimos S Filippatos (ORCID: https://orcid.org/0000-0002-5640-0332)
- Pietro Ameri (ORCID: https://orcid.org/0000-0001-7167-7287)
- Loreena Hill (ORCID: https://orcid.org/0000-0001-5232-0936)
- Dobromir Dobrev (ORCID: https://orcid.org/0000-0002-4612-117X)
- Maurizio Volterrani (ORCID: https://orcid.org/0000-0002-2624-9213)
- Stephan von Haehling (ORCID: https://orcid.org/0000-0002-9818-042X)
- Stefania Paolillo (ORCID: https://orcid.org/0000-0003-4683-0993)
- Giuseppe Ambrosio (ORCID: https://orcid.org/0000-0002-8001-8627)
- Emilia D’Elia (ORCID: https://orcid.org/0000-0002-6682-0074)
- Antonio Nicola Cannata (ORCID: https://orcid.org/0000-0001-7609-6297)
- Marco Metra (ORCID: https://orcid.org/0000-0001-6691-8568)
- Magnus Bäck (ORCID: https://orcid.org/0000-0003-0853-5141)
- Carlo G. Tocchetti (ORCID: https://orcid.org/0000-0001-5983-688X)
- Davide Stolfo (ORCID: https://orcid.org/0000-0002-4538-6811)
- Ovidiu Chioncel (ORCID: https://orcid.org/0000-0002-3197-3628)
- Frieder Braunschweig (ORCID: https://orcid.org/0000-0002-4966-1315)
- Offer Amir (ORCID: https://orcid.org/0000-0002-5624-2450)
- Hassan El‐Tamimi
- Ewa A. Jankowska (ORCID: https://orcid.org/0000-0002-9202-432X)
- Brenda Moura (ORCID: https://orcid.org/0000-0001-6158-7368)
- Felix Lindberg (ORCID: https://orcid.org/0000-0002-7380-9877)
- Sven Waßmann (ORCID: https://orcid.org/0000-0002-4435-2476)
- Hadi Skouri (ORCID: https://orcid.org/0000-0003-0541-4926)
- Massimo Piepoli (ORCID: https://orcid.org/0000-0003-1124-234X)
- Cristiana Vitale (ORCID: https://orcid.org/0000-0003-1111-9894)
- Mehmet Birhan Yılmaz (ORCID: https://orcid.org/0000-0002-8169-8628)
- Basil S. Lewis (ORCID: https://orcid.org/0000-0002-2353-3585)
- Tuvia Ben Gal
- Giuseppe M.C. Rosano
- Abdulla Shehab
- Juan Carlos Kaski
- Marianna Adamo
Institutions
- Karolinska University Hospital (SE)
- University of Ulster (GB)
- University of Leicester (GB)
- Vita-Salute San Raffaele University (IT)
- Inserm (FR)
- Al Ain University (AE)
- Carol Davila University of Medicine and Pharmacy (RO)
- Tel Aviv University (IL)
- St George's, University of London (GB)
- University of Balamand (LB)
- Baylor College of Medicine (US)
- Universidade do Porto (PT)
- University of Milan (IT)
- Dokuz Eylül University (TR)
- National and Kapodistrian University of Athens (GR)
- University of Perugia (IT)
- Hadassah Medical Center (IL)
- Montreal Heart Institute (CA)
- Rabin Medical Center (IL)
- Karolinska Institutet (SE)
- San Raffaele University of Rome (IT)
- Wroclaw Medical University (PL)
- Sheikh Shakhbout Medical City (AE)
- Stockholm South General Hospital (SE)
- Centro de Investigación en Red en Enfermedades Cardiovasculares (ES)
- IRCCS Policlinico San Donato (IT)
- Surgical Specialties (Canada) (CA)
- Ospedale Papa Giovanni XXIII (IT)
- Mohammed Bin Rashid University of Medicine and Health Sciences (AE)
- King's College Hospital NHS Foundation Trust (GB)
- CUF Porto Hospital (PT)
- Armed Forces Hospital (SA)
- Carmel Medical Center (IL)
- Universitätsmedizin Göttingen (DE)
- Mediclinic City Hospital (AE)
- Ospedale Santa Maria della Misericordia di Udine (IT)
- German Centre for Cardiovascular Research (DE)
- IRCCS Ospedale San Raffaele (IT)
- Honey bee and Silkworm Research Unit (IT)
- Ospedale Policlinico San Martino (IT)
- Associazione Italiana Arbitri (IT)
- Hospital Universitari Germans Trias i Pujol (ES)
- French Clinical Research Infrastructure Network (FR)
- Défaillance Cardiovasculaire Aiguë et Chronique
- Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele (IT)
- University of Duisburg-Essen (DE)
- University of Milano-Bicocca (IT)
- University of Naples Federico II (IT)
- University of Göttingen (DE)
- University of Brescia (IT)
- University of Genoa (IT)
- Université de Lorraine (FR)
- Saarland University (DE)
- University for Foreigners Perugia (IT)
- University of Edinburgh (GB)
Publication Details
- Journal
- European Journal of Heart Failure
- Published
- 2025-11-09
- DOI
- https://doi.org/10.1002/ejhf.70090
- Citations
- 3
- Primary Topic
- Medication Adherence and Compliance
- Type
- article
- Field-Weighted Citation Impact
- 4.55
Funders
- Amgen
- Bristol-Myers Squibb
- Eli Lilly and Company
- Pfizer
- AstraZeneca
- GlaxoSmithKline
- Sanofi
- Alnylam Pharmaceuticals
- Edwards Lifesciences
- Boston Scientific Corporation
- Deutsches Zentrum für Herz-Kreislaufforschung
- Amicus Therapeutics
- Impulse Dynamics
- National Institute for Health and Care Research
- British Heart Foundation
- European Commission
- Deutsche Forschungsgemeinschaft
- Daiichi-Sankyo
- Ministero della Salute
- Georg-August-Universität Göttingen
- Novo Nordisk
- Vifor Pharma
- Servier
- Idorsia Pharmaceuticals
- National Institutes of Health
- Respicardia
- Agenzia Italiana del Farmaco, Ministero della Salute
- NIHR Leicester Biomedical Research Centre
- Janssen Research and Development