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Serum drug levels and medication adherence in heart failure: A comparative cohort analysis

Libor Jelinek1, Martin Modrak2, Jan Vaclavik3

  • 1Department of Exercise Medicine and Cardiovascular Rehabilitation, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic.

Biomedical Papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia
|March 12, 2025
PubMed

Insights

Medication adherence in heart failure patients was assessed using serum drug levels. While most patients were adherent, the 2020 cohort showed lower adherence compared to 2018, despite similar heart failure severity.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Medicine

Background:

  • Medication adherence is crucial for managing chronic heart failure (HF).
  • Direct methods like serum drug level testing offer objective adherence assessment.
  • Understanding adherence trends over time is important for patient outcomes.

Purpose of the Study:

  • To compare medication adherence in two heart failure patient cohorts.
  • To evaluate changes in adherence between 2018 and 2020 using serum drug levels.
  • To identify factors associated with adherence in HF patients.

Main Methods:

  • A prospective, monocentric registry (LEVEL-CHF) was used.
  • Two cohorts of stable HF with reduced ejection fraction patients were enrolled in 2018 and 2020.
  • Serum drug levels were employed for direct adherence detection.

Main Results:

  • 81% of patients were fully adherent; 19% showed varying degrees of non-adherence.
  • The 2020 cohort demonstrated significantly lower medication adherence than the 2018 cohort (P<0.01).
  • Increased BMI and fasting glycemia were observed in 2020 compared to 2018.

Conclusions:

  • Most heart failure patients exhibited full medication adherence.
  • Serum drug level testing is an effective adherence assessment tool in clinical practice.
  • No significant clinical differences were found between adherent and non-adherent HF patients.
Abstract

Keywords:
adherencecomplianceheart failurepharmacotherapyserum drug levels

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