Enhancing therapy adherence in heart failure: results from the SupportHeart trial

Abstract Background Previous research and Randomized Control Trials (RCTs) have identified non adherence as a major challenge in heart failure(HF) management, particularly in non pharmacological therapies. Aim This secondary analysis of the SupportHeart trial aimed to assess the effectiveness of an individualized nurse-led multidisciplinary supportive care program in improving therapy adherence among HF patients. Adherence was measured using the Greek version of the validated tools: 1. The 9-item European heart failure self-care behaviour scale (Gr9-EHFScB) and 2. The Self-Care Heart Failure Index (Gr-SCHFI). Methods The studied followed HF patients over one year, assessing them at five time points: baseline, one month, three months, six months and one year. Group comparisons at each time point were conducted using Welch's t-test, while differences in loss to follow-up between the intervention (IG) and control groups (CG) were analyzed using Fisher's extract test. The impact of the intervention on adherence score (Gr9-EHFScB, Gr-SCHFI) was evaluated using the Linear Mixed Model Effects (LMME)with the scale scores at the depended variable and group (CG, CG), time point and their interaction (Group X Time) as independent variable. Results A total of two hundred two patients participated in the study, with a mean age of of 71.8 years (SD = 10.9). The 65 of them (32%) were women. LMME results demonstrated a statistically significant positive effect of the intervention on the adherence at all time points. Both tools used showed the same effect across all subscales (Figures 1 & 2). Conclusion The SupportHeart program reinforces the value of ongoing support for a nurse-led multidisciplinary team in improving therapy adherence among HF patients. Its pragmatic methodology approach offers a scalable model of individualized care across diverse healthcare systems.Results using the tool Gr9-EHFScB Results using the tool Gr-SCHFI