This post was written by Chief Medical Officer Jared Adams and is the second part of a Self-Care Series.
Self-care means filling and refilling prescriptions, incorporating medication taking into the daily routine, and managing medication changes in response to changes in symptoms, travel or illness. Adherence to medication varies widely depending on the population, disease, and type of medication, with as few as 2% taking the medication as prescribed to over 90% in life threatening conditions such as organ transplant where even one missed dose can lead to organ rejection. Even though heart failure is life threatening, only 60% maintained their ACE-inhibitor prescription after discharge. The reasons patients gave for non-adherence vary but lack of clear instructions was by far the most important factor. Approximately 57% stated confusion over discharge instructions, 22% stated confusion over conflicting instructions from different doctors, 18% cited medication costs, 9% didn’t think they needed it, and 7% were worried about side effects.
Recognizing and acting on changes in symptoms is an important part of self-care. Research has found that most patients who experience symptoms changes in heart failure, such as weight change, wait for a few days until urgent action is critical. An increase in weight could signal worsening heart failure as fluid accumulates in the extremities, but fewer than half of heart failure patients reported weighing themselves daily. Patients who were able to recognize symptom changes such as weight gain, were more likely to make the self-care decisions that would prevent their symptoms from worsening, such as restricting dietary salt and fluid or increasing diuretic dose.