Evidence map›Paper›PMID 40637306›Full record

ArticleEuropean journal of heart failure2025

Medication adherence in patients with acutely decompensated heart failure: A cross-sectional study in the emergency department (ADHF-ED).

Michael Kunz, Juel Maalouli Schaar, Katharina R Welker, Lucas Lauder, Felix Götzinger, Ingrid Kindermann, Martin Schulz, Michael Böhm, Markus R Meyer, Felix Mahfoud

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06459115 (Adherence to Medication in Patients With Acute Decompensated Heart Failure), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06459115 completednot on this map

Adherence to Medication in Patients With Acute Decompensated Heart Failure: a Cross-sectional Study at the Emergency Department (ADHF-ED= Adherence to Medication in Patients With Acute Decompensated Heart Failure at the Emergency Department)

Typeobservational_patient_registrySponsorUniversität des SaarlandesRan2023 to 2024Enrolled100ConditionsAcute Decompensated Heart Failure
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Michael KunzDepartment of Cardiology, University Heart Center Basel, University Hospital Basel, Basel, Switzerland.
Juel Maalouli SchaarDepartment of Experimental and Clinical Toxicology and Pharmacology, Center for Molecular Signaling (PZMS), PharmaScienceHub (PSH), Saarland University, Homburg, Germany.
Katharina R WelkerDepartment of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, University Hospital Saarland, Saarland University, Homburg, Germany.
Lucas LauderDepartment of Cardiology, University Heart Center Basel, University Hospital Basel, Basel, Switzerland.
Felix GötzingerDepartment of Cardiology, University Heart Center Basel, University Hospital Basel, Basel, Switzerland.
Ingrid KindermannDepartment of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, University Hospital Saarland, Saarland University, Homburg, Germany.
Martin SchulzInstitute of Pharmacy, Freie Universität Berlin, Berlin, Germany.
Michael BöhmDepartment of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, University Hospital Saarland, Saarland University, Homburg, Germany.
Markus R MeyerDepartment of Experimental and Clinical Toxicology and Pharmacology, Center for Molecular Signaling (PZMS), PharmaScienceHub (PSH), Saarland University, Homburg, Germany.
Felix MahfoudDepartment of Cardiology, University Heart Center Basel, University Hospital Basel, Basel, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsNon-adherence to guideline-directed medical therapy may worsen outcomes in chronic heart failure (CHF). Objectively assessed adherence in patients presenting with acutely decompensated heart failure (ADHF) remains largely unexplored. This study evaluated adherence to medication in patients with ADHF presenting in the emergency department. METHODS AND

resultsThis cross-sectional study assessed medication adherence using both indirect (self-reported) and direct methods (qualitative toxicological analysis in urine). A total of 100 patients were included of whom 61% were men, with a mean age of 77.9 ± 10.1 years, and a median N-terminal pro-B-type natriuretic peptide level of 4846 pg/ml. In 39% of patients, all prescribed CHF medications were detected in urine, indicating full adherence. Partial adherence was observed in 39% of patients with one prescribed CHF medication not detected. Non-adherence, defined as the absence of ≥2 prescribed drugs, was observed in 22% of patients. Non-adherent patients had a significantly higher number of CHF medications prescribed compared with partially adherent (p = 0.0047) and adherent (p = 0.0002) patients and had a significantly higher pill burden than adherent patients (p = 0.002). Non-adherent patients were younger than partially adherent (p = 0.0144) and adherent (p = 0.0054) patients. Adherent patients were significantly more likely to have an abnormal DemTect cognitive screening test result (p = 0.049). Medication prepared by a third party, such as caregiver or pharmacist, reduced the likelihood of both non- and partial adherence. Self-reported adherence monitoring was found to be inaccurate.

conclusionsAdherence to CHF medication in patients presenting with ADHF was low. Non-adherence represents a significant contributor to worsening CHF, potentially leading to ADHF hospitalization. Further research is needed to develop feasible and validated tools for assessing medication adherence in CHF and ADHF, using toxicological testing as reference standard.

Indexed as

Emergency Service, HospitalHeart FailureAcute DiseaseAgedAged, 80 and overCross-Sectional StudiesFemaleHumansMaleNatriuretic Peptide, BrainNatriuretic Peptide, BrainAcutely decompensated heart failureAdherenceGuideline‐directed medical therapyHeart failure hospitalizationSelf‐reportToxicological analysis

Identifiers

PMID40637306
PMCPMC12803543

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.