Condition-related factors reflect the challenges arising
from the disease-specific symptoms, level of disability,
progression and severity of the disease, and the effectiveness
of available treatments [15]. Because the trajectory of
HF alternates between an acute situation often requiring
hospitalization to a chronic state with indiscriminate
symptoms, patients often have difficulty understanding that
they are living with a chronic illness that requires consistent
medication treatment, constant monitoring of subtle condition
changes and the knowledge of who to call in case of
impending decompensation [14,34]. Debilitating symptoms
and distressed emotions have been identified as significant
barriers to compliance [48]. In addition, there is growing
awareness that HF is associated with physiologic changes in
other organ systems that influence the patient’s ability to
comply with the therapeutic plan. Cognitive dysfunction is
probably the most important of these changes [51].
Depression is also an important factor influencing compliance
[52]. At least 11% of ambulatory [53] and 50% of
hospitalized HF patients are depressed [54,55]. The odds of non-compliance are three times higher in depressed than
non-depressed patients
Condition-related factors reflect the challenges arisingfrom the disease-specific symptoms, level of disability,progression and severity of the disease, and the effectivenessof available treatments [15]. Because the trajectory ofHF alternates between an acute situation often requiringhospitalization to a chronic state with indiscriminatesymptoms, patients often have difficulty understanding thatthey are living with a chronic illness that requires consistentmedication treatment, constant monitoring of subtle conditionchanges and the knowledge of who to call in case ofimpending decompensation [14,34]. Debilitating symptomsand distressed emotions have been identified as significantbarriers to compliance [48]. In addition, there is growingawareness that HF is associated with physiologic changes inother organ systems that influence the patient’s ability tocomply with the therapeutic plan. Cognitive dysfunction isprobably the most important of these changes [51].Depression is also an important factor influencing compliance[52]. At least 11% of ambulatory [53] and 50% ofhospitalized HF patients are depressed [54,55]. The odds of non-compliance are three times higher in depressed thannon-depressed patients
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