Adherence to guideline‐directed medical treatments in heart failure. A scientific statement of the Heart Failure Association ( HFA ) of the ESC and the ESC Working Group on Cardiovascular Pharmacotherapy

Gianluigi Savarese; Felix Lindberg; Antonio Cannata; Marianna Adamo; Giuseppe Ambrosio; Pietro Ameri; Markus S. Anker; Magnus Bäck; Antoni Bayes‐Genis; Tuvia Ben Gal; Frieder Braunschweig; Ovidiu Chioncel; Emilia D'Elia; Hassan El‐Tamimi; Gerasimos Filippatos; Nicolas Girerd; Loreena Hill; Ewa Jankowska; Kamlesh Khunti; Basil S. Lewis; Brenda Moura; Offer Amir; Stefania Paolillo; Massimo Piepoli; Abdulla Shehab; Maggie Simpson; Hadi Skouri; Davide Stolfo; Carlo Gabriele Tocchetti; Cristiana Vitale; Maurizio Volterrani; Stephan von Haehling; Sven Wassmann; Mehmet Birhan Yilmaz; Juan Carlos Kaski; Dobromir Dobrev; Marco Metra; Giuseppe M.C. Rosano

doi:10.1002/ejhf.70090

Adherence to guideline‐directed medical treatments in heart failure. A scientific statement of the Heart Failure Association ( HFA ) of the ESC and the ESC Working Group on Cardiovascular Pharmacotherapy

Gianluigi Savarese
, Felix Lindberg
, Antonio Cannata
, Marianna Adamo
, Giuseppe Ambrosio
, Pietro Ameri
, Markus S. Anker
, Magnus Bäck
, Antoni Bayes‐Genis
, Tuvia Ben Gal
, Frieder Braunschweig
, Ovidiu Chioncel
, Emilia D'Elia
, Hassan El‐Tamimi
, Gerasimos Filippatos
, Nicolas Girerd
, Loreena Hill
, Ewa Jankowska
, Kamlesh Khunti
, Basil S. Lewis

Brenda Moura, Offer Amir, Stefania Paolillo, Massimo Piepoli, Abdulla Shehab, Maggie Simpson, Hadi Skouri, Davide Stolfo, Carlo Gabriele Tocchetti, Cristiana Vitale, Maurizio Volterrani, Stephan von Haehling, Sven Wassmann, Mehmet Birhan Yilmaz, Juan Carlos Kaski, Dobromir Dobrev, Marco Metra, Giuseppe M.C. Rosano

Research output: Contribution to journal › Article › peer-review

14 Citations (Scopus)

11 Downloads (Pure)

Abstract

Heart failure (HF) affects over 60 million individuals globally. Contemporary guideline‐directed medical therapies (GDMT) reduce cardiovascular mortality and HF hospitalizations. However, medication non‐adherence represents a critical barrier limiting real‐world efficacy of GDMT. This scientific statement aims to provide a comprehensive framework for understanding, measuring, and addressing medication non‐adherence in HF management across diverse healthcare settings. Addressing medication non‐adherence requires systematic, multifaceted approaches targeting individual patient barriers while implementing system‐level interventions. Polypills, digital monitoring platforms, enhanced patient education and empowerment, and multidisciplinary care models represent promising strategies to optimize therapeutic adherence and improve clinical outcomes in HF management.

Original language	English
Pages (from-to)	2716-2731
Number of pages	16
Journal	European Journal of Heart Failure
Volume	27
Issue number	12
Early online date	9 Nov 2025
DOIs	https://doi.org/10.1002/ejhf.70090
Publication status	Published (in print/issue) - 1 Dec 2025

Bibliographical note

Publisher Copyright:
© 2025 The Author(s). European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

Funding

K.K. is supported by the National Institute for Health and Care Research(NIHR) Applied Research Collaboration East Midlands (ARC EM), NIHR Global Research Centre for Multiple Long Term Conditions, NIHR Cross NIHR Collaboration for Multiple Long Term Conditions, NIHR Leicester Biomedical Research Centre (BRC) and the British Heart Foundation (BHF)Centre of Excellence. D.D. is supported by grants from National Institutes of Health (R01HL136389, R01HL163277, R01HL160992, R01HL165704,R01HL164838, and R01HL176651), the Deutsche Forschungsgemeinschaft (Research Training Group 2989), and the European Union (large-scale network grant no. 965286, MAESTRIA).

Funders	Funder number
AstraZeneca
Novartis
Merck
Deutsche Forschungsgemeinschaft
British Heart Foundation
Novo Nordisk AS
MEDTRONIC
Pfizer
Bayer
National Institutes of Health	R01HL176651, R01HL136389, R01HL160992, R01HL163277, R01HL164838, R01HL165704
European Commission	965286

Keywords

Fixed‐dose combinations
Heart failure
Guidelines
Multidisciplinary
Adherence
Polypill
Education
Digital
Fixed-dose combinations
Cardiovascular Agents/therapeutic use
Humans
Heart Failure/drug therapy
Medication Adherence
Guideline Adherence
Societies, Medical
Cardiology
Practice Guidelines as Topic

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Savarese, G., Lindberg, F., Cannata, A., Adamo, M., Ambrosio, G., Ameri, P., Anker, M. S., Bäck, M., Bayes‐Genis, A., Ben Gal, T., Braunschweig, F., Chioncel, O., D'Elia, E., El‐Tamimi, H., Filippatos, G., Girerd, N., Hill, L., Jankowska, E., Khunti, K., ... Rosano, G. M. C. (2025). Adherence to guideline‐directed medical treatments in heart failure. A scientific statement of the Heart Failure Association ( HFA ) of the ESC and the ESC Working Group on Cardiovascular Pharmacotherapy. European Journal of Heart Failure, 27(12), 2716-2731. https://doi.org/10.1002/ejhf.70090

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title = "Adherence to guideline‐directed medical treatments in heart failure. A scientific statement of the Heart Failure Association ( HFA ) of the ESC and the ESC Working Group on Cardiovascular Pharmacotherapy",

abstract = "Heart failure (HF) affects over 60 million individuals globally. Contemporary guideline‐directed medical therapies (GDMT) reduce cardiovascular mortality and HF hospitalizations. However, medication non‐adherence represents a critical barrier limiting real‐world efficacy of GDMT. This scientific statement aims to provide a comprehensive framework for understanding, measuring, and addressing medication non‐adherence in HF management across diverse healthcare settings. Addressing medication non‐adherence requires systematic, multifaceted approaches targeting individual patient barriers while implementing system‐level interventions. Polypills, digital monitoring platforms, enhanced patient education and empowerment, and multidisciplinary care models represent promising strategies to optimize therapeutic adherence and improve clinical outcomes in HF management.",

keywords = "Fixed‐dose combinations, Heart failure, Guidelines, Multidisciplinary, Adherence, Polypill, Education, Digital, Fixed-dose combinations, Cardiovascular Agents/therapeutic use, Humans, Heart Failure/drug therapy, Medication Adherence, Guideline Adherence, Societies, Medical, Cardiology, Practice Guidelines as Topic",

author = "Gianluigi Savarese and Felix Lindberg and Antonio Cannata and Marianna Adamo and Giuseppe Ambrosio and Pietro Ameri and Anker, \{Markus S.\} and Magnus B{\"a}ck and Antoni Bayes‐Genis and \{Ben Gal\}, Tuvia and Frieder Braunschweig and Ovidiu Chioncel and Emilia D'Elia and Hassan El‐Tamimi and Gerasimos Filippatos and Nicolas Girerd and Loreena Hill and Ewa Jankowska and Kamlesh Khunti and Lewis, \{Basil S.\} and Brenda Moura and Offer Amir and Stefania Paolillo and Massimo Piepoli and Abdulla Shehab and Maggie Simpson and Hadi Skouri and Davide Stolfo and Tocchetti, \{Carlo Gabriele\} and Cristiana Vitale and Maurizio Volterrani and \{von Haehling\}, Stephan and Sven Wassmann and Yilmaz, \{Mehmet Birhan\} and Kaski, \{Juan Carlos\} and Dobromir Dobrev and Marco Metra and Rosano, \{Giuseppe M.C.\}",

note = "Publisher Copyright: {\textcopyright} 2025 The Author(s). European Journal of Heart Failure published by John Wiley \& Sons Ltd on behalf of European Society of Cardiology.",

year = "2025",

month = dec,

day = "1",

doi = "10.1002/ejhf.70090",

language = "English",

volume = "27",

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}

Savarese, G, Lindberg, F, Cannata, A, Adamo, M, Ambrosio, G, Ameri, P, Anker, MS, Bäck, M, Bayes‐Genis, A, Ben Gal, T, Braunschweig, F, Chioncel, O, D'Elia, E, El‐Tamimi, H, Filippatos, G, Girerd, N, Hill, L, Jankowska, E, Khunti, K, Lewis, BS, Moura, B, Amir, O, Paolillo, S, Piepoli, M, Shehab, A, Simpson, M, Skouri, H, Stolfo, D, Tocchetti, CG, Vitale, C, Volterrani, M, von Haehling, S, Wassmann, S, Yilmaz, MB, Kaski, JC, Dobrev, D, Metra, M & Rosano, GMC 2025, 'Adherence to guideline‐directed medical treatments in heart failure. A scientific statement of the Heart Failure Association ( HFA ) of the ESC and the ESC Working Group on Cardiovascular Pharmacotherapy', European Journal of Heart Failure, vol. 27, no. 12, pp. 2716-2731. https://doi.org/10.1002/ejhf.70090

Adherence to guideline‐directed medical treatments in heart failure. A scientific statement of the Heart Failure Association ( HFA ) of the ESC and the ESC Working Group on Cardiovascular Pharmacotherapy. / Savarese, Gianluigi; Lindberg, Felix; Cannata, Antonio et al.
In: European Journal of Heart Failure, Vol. 27, No. 12, 01.12.2025, p. 2716-2731.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Adherence to guideline‐directed medical treatments in heart failure. A scientific statement of the Heart Failure Association ( HFA ) of the ESC and the ESC Working Group on Cardiovascular Pharmacotherapy

AU - Savarese, Gianluigi

AU - Lindberg, Felix

AU - Cannata, Antonio

AU - Adamo, Marianna

AU - Ambrosio, Giuseppe

AU - Ameri, Pietro

AU - Anker, Markus S.

AU - Bäck, Magnus

AU - Bayes‐Genis, Antoni

AU - Ben Gal, Tuvia

AU - Braunschweig, Frieder

AU - Chioncel, Ovidiu

AU - D'Elia, Emilia

AU - El‐Tamimi, Hassan

AU - Filippatos, Gerasimos

AU - Girerd, Nicolas

AU - Hill, Loreena

AU - Jankowska, Ewa

AU - Khunti, Kamlesh

AU - Lewis, Basil S.

AU - Moura, Brenda

AU - Amir, Offer

AU - Paolillo, Stefania

AU - Piepoli, Massimo

AU - Shehab, Abdulla

AU - Simpson, Maggie

AU - Skouri, Hadi

AU - Stolfo, Davide

AU - Tocchetti, Carlo Gabriele

AU - Vitale, Cristiana

AU - Volterrani, Maurizio

AU - von Haehling, Stephan

AU - Wassmann, Sven

AU - Yilmaz, Mehmet Birhan

AU - Kaski, Juan Carlos

AU - Dobrev, Dobromir

AU - Metra, Marco

AU - Rosano, Giuseppe M.C.

PY - 2025/12/1

Y1 - 2025/12/1

N2 - Heart failure (HF) affects over 60 million individuals globally. Contemporary guideline‐directed medical therapies (GDMT) reduce cardiovascular mortality and HF hospitalizations. However, medication non‐adherence represents a critical barrier limiting real‐world efficacy of GDMT. This scientific statement aims to provide a comprehensive framework for understanding, measuring, and addressing medication non‐adherence in HF management across diverse healthcare settings. Addressing medication non‐adherence requires systematic, multifaceted approaches targeting individual patient barriers while implementing system‐level interventions. Polypills, digital monitoring platforms, enhanced patient education and empowerment, and multidisciplinary care models represent promising strategies to optimize therapeutic adherence and improve clinical outcomes in HF management.

AB - Heart failure (HF) affects over 60 million individuals globally. Contemporary guideline‐directed medical therapies (GDMT) reduce cardiovascular mortality and HF hospitalizations. However, medication non‐adherence represents a critical barrier limiting real‐world efficacy of GDMT. This scientific statement aims to provide a comprehensive framework for understanding, measuring, and addressing medication non‐adherence in HF management across diverse healthcare settings. Addressing medication non‐adherence requires systematic, multifaceted approaches targeting individual patient barriers while implementing system‐level interventions. Polypills, digital monitoring platforms, enhanced patient education and empowerment, and multidisciplinary care models represent promising strategies to optimize therapeutic adherence and improve clinical outcomes in HF management.

KW - Fixed‐dose combinations

KW - Heart failure

KW - Guidelines

KW - Multidisciplinary

KW - Adherence

KW - Polypill

KW - Education

KW - Digital

KW - Fixed-dose combinations

KW - Cardiovascular Agents/therapeutic use

KW - Humans

KW - Heart Failure/drug therapy

KW - Medication Adherence

KW - Guideline Adherence

KW - Societies, Medical

KW - Cardiology

KW - Practice Guidelines as Topic

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UR - https://www.scopus.com/pages/publications/105021334591

U2 - 10.1002/ejhf.70090

DO - 10.1002/ejhf.70090

M3 - Article

C2 - 41208145

SN - 1879-0844

VL - 27

SP - 2716

EP - 2731

JO - European Journal of Heart Failure

JF - European Journal of Heart Failure

IS - 12

ER -

Savarese G, Lindberg F, Cannata A, Adamo M, Ambrosio G, Ameri P et al. Adherence to guideline‐directed medical treatments in heart failure. A scientific statement of the Heart Failure Association ( HFA ) of the ESC and the ESC Working Group on Cardiovascular Pharmacotherapy. European Journal of Heart Failure. 2025 Dec 1;27(12):2716-2731. Epub 2025 Nov 9. doi: 10.1002/ejhf.70090

Adherence to guideline‐directed medical treatments in heart failure. A scientific statement of the Heart Failure Association ( HFA ) of the ESC and the ESC Working Group on Cardiovascular Pharmacotherapy

Abstract

Bibliographical note

Funding

Keywords

Access to Document

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