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Efficacy of a comprehensive medication management programme on medication adherence in patients with heart failure

Kazuki Kagami1, Toru Kondo2, Sho Suzuki3

  • 1Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan.

BMJ Open
|June 25, 2026
PubMed

Insights

A comprehensive medication management program improved medication adherence in heart failure patients with polypharmacy. This approach helps optimize guideline-directed medical therapy (GDMT) and reduce potentially inappropriate medications.

Area of Science:

  • Cardiology
  • Pharmacology
  • Geriatrics

Background:

  • Guideline-directed medical therapy (GDMT) is crucial for reducing morbidity and mortality in heart failure (HF).
  • Elderly HF patients often have multiple comorbidities, leading to polypharmacy (≥5 regular oral medications).
  • Polypharmacy can decrease adherence to GDMT, compromise treatment optimization, and worsen clinical outcomes in HF patients.

Purpose of the Study:

  • To evaluate if a comprehensive medication management program (CMMP) improves medication adherence in HF patients with polypharmacy.
  • To compare the efficacy of CMMP versus standard care in enhancing adherence at 6 months.

Main Methods:

  • Prospective, multicenter, randomized, open-label trial (PERSEUS-HF) with 300 HF patients and polypharmacy.
  • Intervention group received CMMP including deprescribing, medication education, GDMT optimization, and simplified dosing.
  • Control group received standard care. Primary endpoint: change in Adherence Starts with Knowledge 20 score at 6 months.

Main Results:

  • The PERSEUS-HF trial is designed to evaluate the efficacy of CMMP in improving medication adherence.
  • Results will indicate whether CMMP leads to a significant improvement in adherence compared to standard care.

Conclusions:

  • CMMP shows promise for improving medication adherence in heart failure patients with polypharmacy.
  • This intervention may help optimize GDMT and improve clinical outcomes in this vulnerable population.
Abstract

Keywords:
Heart failurePolypharmacyResearch Design

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