From the Guidelines
Improving compliance with heart failure regimens among low-income patients requires a multifaceted approach that addresses financial, educational, and logistical barriers, with a strong emphasis on prescribing affordable medications and providing clear education on self-management activities. According to the most recent study 1, guideline-directed medical therapy (GDMT) is the foundation for heart failure (HF) treatment, and it improves quality of life, lowers mortality, and decreases hospitalizations for patients with HF. However, HF-related expenditures have increased over time, and cost may contribute to suboptimal adherence to HF medications.
Some key strategies to improve compliance include:
- Prescribing affordable medications such as generic ACE inhibitors (lisinopril 10-40 mg daily), beta-blockers (carvedilol 3.125-25 mg twice daily or metoprolol succinate 25-200 mg daily), and diuretics (furosemide 20-80 mg daily) 1
- Utilizing patient assistance programs, medication discount cards, and 340B pharmacy programs to reduce medication costs 1
- Simplifying medication regimens by using once-daily dosing when possible and combination pills to improve adherence 1
- Providing clear education about the importance of daily weight monitoring, salt restriction (less than 2,000 mg sodium daily), fluid restriction (typically 1.5-2 liters daily), and regular physical activity 1
- Using teach-back methods to ensure understanding and providing written materials at appropriate literacy levels 1
- Regular follow-up through telehealth options when transportation is limited, home health services for monitoring, and community health worker involvement to help maintain regimen adherence 1
These approaches address the common barriers faced by low-income patients, including cost constraints, health literacy challenges, transportation difficulties, and competing life priorities, ultimately improving heart failure outcomes and reducing hospitalizations. As noted in the study 1, many patients with HF in low socioeconomic positions face significant challenges in accessing resources required to manage their condition, and addressing these social determinants of health is crucial to improving outcomes.
From the Research
Compliance of Low Income Class in Maintaining Heart Failure Regimen
- There are no direct research papers to assist in answering this question, as the provided studies focus on the treatment and management of heart failure rather than compliance of low-income classes in maintaining heart failure regimens.
- However, the studies suggest that heart failure treatment regimens often involve multiple medications, including angiotensin-converting enzyme inhibitors, beta-blockers, diuretics, and aldosterone antagonists 2, 3.
- The cost and complexity of these regimens may pose challenges for low-income patients, potentially affecting their ability to comply with treatment plans.
- Some studies discuss the efficacy and safety of specific medications, such as lisinopril, in the treatment of heart failure and hypertension 4, 5, 6.
- These studies may provide indirect insights into the potential challenges of maintaining heart failure regimens, but further research is needed to specifically address the compliance of low-income classes in this context.