General practice organisational models and heart failure medication adherence: multi-level evidence from a regional cohort in Emilia-Romagna, Italy

Organisational arrangements alone may be insufficient to improve adherence in heart failure care. Their effectiveness likely depends on how they are implemented and supported at the local level, through clinical leadership, specialist involvement, and integration across care settings. As new national reforms promote broader structural change, our findings underscore the importance of local facilitators and context-sensitive implementation. These insights are particularly relevant for understanding the operational strengths and weaknesses of legacy models that are now being phased out.