UPMC Internal Medicine, UPMC Montefiore Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Heart Fail Clin. 2013 Jan;9(1):49-58. doi: 10.1016/j.hfc.2012.09.004. Epub 2012 Oct 24.
Poor adherence to therapeutic regimens is a significant impediment to improving clinical outcomes in the HF population. Typical rates of adherence to prescribed medications, low-sodium diets, and aerobic exercise programs remain lower than that needed to decrease morbidity and mortality associated with HF. Factors contributing to poor adherence include multiple comorbidities, clinical depression, and decreased cognitive functioning. HF education and programs to enhance self-management skills have improved patient quality of life but have yet to decrease mortality or rehospitalization rates significantly. Telemonitoring to improve adherence behaviors and self-management interventions within broader HF management programs have demonstrated significant clinical improvements in this population.
治疗方案的依从性差是改善心力衰竭患者临床结局的重大障碍。患者对医嘱药物、低盐饮食和有氧运动方案的依从率仍然低于降低心力衰竭相关发病率和死亡率所需的水平。导致依从性差的因素包括多种合并症、临床抑郁和认知功能下降。心力衰竭教育和提高自我管理技能的计划改善了患者的生活质量，但尚未显著降低死亡率或再住院率。远程监测改善了依从行为，在更广泛的心力衰竭管理计划中进行自我管理干预，这在该人群中显示出了显著的临床改善。
