Medication Management for People with Heart Failure

Medicines and lifestyle changes will be part of your heart failure (HF) treatment plan.¹ Medication can improve your heart function, delay the progression of your heart failure, and/or prevent a future cardiac event. Both patients and caregivers should understand what drugs are being taken and why.¹

Heart failure is a chronic condition that affects nearly 6 million people, creating substantial medical costs.² Medication adherence, taking your medications as prescribed, can mean fewer hospitalizations and emergency room visits, and lower health care costs.^2,3 Reasons people may not take their medications can include an absence of symptoms, high costs, side effects, cognitive decline, too many medications, and difficulty swallowing large pills.²

It is always important to tell your healthcare team about any drugs you are already taking, including over-the-counter products, vitamins, herbs, and supplements.¹ Keep a comprehensive medication list. Carry a copy with you and give one to your caregiver and your healthcare team.⁴ Your doctor may provide you with one or you can find medication lists online.

Medication Tracking

Information typically tracked includes:^1,3

• Medication name
• Dose
• Frequency
• Time

Other information that can be useful:^1,3

• Pill appearance
• Purpose of medication
• Prescribing doctor
• Pharmacy information
• Special instructions

The importance of education

Drug therapy is the most common treatment for heart failure. Treatment can involve taking multiple medications at different times and the regimen can be complex. Your health care team should stress the importance of taking all medications as prescribed.² Medication adherence can reduce hospitalizations and improve survival.

Medication adherence

Reports show that people who take their medications regularly go more consecutive days without adverse events.² They spend less time in the hospital and more time enjoying life. Some people have difficulty keeping to their medication schedule. They may forget or not like the way they feel after they take the medications. Others stop taking them because they feel well and do not think they need them.

Unintentional non-adherence is more often related to factors like age, gender, ethnicity, and socioeconomic status; or treatment/provider factors like dosing frequency, number of medications, and poor provider communication.² As drug costs and co-payments increase, medication adherence rates decrease.² Some people reduce their dose to make their prescriptions last longer. If cost is an issue, talk to your provider about medication assistance plans or whether there are lower-cost options available.

Take medicines safely and effectively

It is key for patients and caregivers to have a basic understanding of all medications currently being taken. Share a list of current medications with all your healthcare providers, including all non-prescription products. This will aid the healthcare team in making prescribing decisions that avoid drug interactions. When not used as prescribed or not taken effectively and safely, people can develop medication-related problems.

Caregivers can help to identify real or possible medication issues.⁴ Any side effects that develop should be reported. There may be alternatives available.³ Each person needs to find a system that works for them because medications need to be taken at a particular dosage, at specified times, and for a specific period of time.⁴ Medications may work more effectively when taken correctly and combined with lifestyle changes.²

Caregiver involvement

Many caregivers are involved in the management of medications.⁴ They have taken the time to understand the intended use, dosing directions, side effects, and possible interactions.

Patients and caregivers alike should know:^3-4

• The reason for each medicine and how it works
• How to know if the medication is working
• Side effects or interactions with other medications
• Any restrictions on foods or activities
• What happens if a dose is missed
• If the medicine has to be swallowed whole or if it can be chewed, crushed, dissolved, or mixed with other medicines.

How to track medications

Scheduling many different medications throughout the day can be hard to manage. Some people keep a log, others use pillboxes that can help you sort pills by day and time of taking. Caregivers can sort pills at the beginning of each week to ease the process. Some pharmacies can deliver pill packs that are presorted for each day and time. Alarms can be used to sound at the time for each dose.^3-4

Research has shown that the more medications a person takes, the greater the risk of experiencing a medication-related problem. Questions to consider are: Is the medication needed and is it the most appropriate one? Is it the right dose? Can it interact with other medications? Are there new or additional medications that should be considered? Are any current medications unnecessary, or are there any old medications you take on the list that should be discontinued or discarded?⁴

These questions should be directed to the healthcare team. Medications should be stored together in a cool dry place unless refrigeration is required. This will make it easier to sort and track medications and help if there is an emergency.⁴