Table 10

Interventions to Improve Adherence

ExampleScenarioIntervention
Medication educationPatient confusion about polypharmacyPharmacist and other clinician-based education
Disease educationMisunderstanding about HF and its managementSupport groups, one-on-one disease teaching
Improved integration of careFragmented care due to multiple comorbiditiesTeam-based care (see answers to Issues 4 and 8), involvement of a case manager. Effective use of electronic health record and patient portal access
Self-management teachingChallenges in salt avoidance or fluid restrictionClinic and home-based nursing program.
Self-monitoringDifficulties in achieving optimal fluid and weight monitoring.Home-based monitoring programs for select patients, biomarker and/or (for those with implantable devices) impedance monitoring in the office, in select patients implantable pulmonary artery pressure monitoring.