How to optimize the adherence to a guideline-directed medical therapy in the secondary prevention of cardiovascular diseases: a clinical consensus statement from the European Association of Preventive Cardiology

Roberto F E Pedretti; Dominique Hansen; Marco Ambrosetti; Maria Back; Thomas Berger; Mariana Cordeiro Ferreira; Véronique Cornelissen; Constantinos H Davos; Wolfram Doehner; Carmen de Pablo Y Zarzosa; Ines Frederix; Andrea Greco; Donata Kurpas; Matthias Michal; Elena Osto; Susanne S Pedersen; Rita Esmeralda Salvador; Maria Simonenko; Patrizia Steca; David R Thompson; Matthias Wilhelm; Ana Abreu

doi:10.1093/eurjpc/zwac204

How to optimize the adherence to a guideline-directed medical therapy in the secondary prevention of cardiovascular diseases: a clinical consensus statement from the European Association of Preventive Cardiology

Eur J Prev Cardiol. 2023 Jan 24;30(2):149-166. doi: 10.1093/eurjpc/zwac204.

Authors

Roberto F E Pedretti¹, Dominique Hansen^{2

3}, Marco Ambrosetti⁴, Maria Back^{5

6}, Thomas Berger⁷, Mariana Cordeiro Ferreira⁸, Véronique Cornelissen⁹, Constantinos H Davos¹⁰, Wolfram Doehner^{11

12

13

14}, Carmen de Pablo Y Zarzosa¹⁵, Ines Frederix^{16

17

18}, Andrea Greco¹⁹, Donata Kurpas²⁰, Matthias Michal^{21

22}, Elena Osto²³, Susanne S Pedersen^{24

25}, Rita Esmeralda Salvador²⁶, Maria Simonenko²⁷, Patrizia Steca²⁸, David R Thompson²⁹, Matthias Wilhelm³⁰, Ana Abreu³¹

Affiliations

¹ Cardiovascular Department, IRCCS MultiMedica, Sesto San Giovanni, Milano, Italy.
² REVAL/BIOMED, Hasselt University, Hasselt, Belgium.
³ Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium.
⁴ Cardiovascular Rehabilitation Unit, ASST Crema, Santa Marta Hospital, Rivolta D'Adda, Italy.
⁵ Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden.
⁶ Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden.
⁷ Cardiomed Linz, St.John of God Hospital Linz, Linz, Austria.
⁸ Psychologist, Centro de Reabilitação Cardiovascular do Centro Universitário Hospitalar Lisboa Norte, Portugal.
⁹ Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
¹⁰ Cardiovascular Research Laboratory, Biomedical Research Foundation, Academy of Athens, Athens, Greece.
¹¹ BIH Center for Regenerative Therapies (BCRT), Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany.
¹² Department of Cardiology (Virchow Klinikum), Charité Universitätsmedizin Berlin and German, Berlin, Germany.
¹³ Centre for Cardiovascular Research (DZHK), partner site Berlin, Berlin, Germany.
¹⁴ Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany.
¹⁵ Department of Cardiology, University Hospital Ramón y Cajal, Madrid, Spain.
¹⁶ Heart Centre Hasselt, Jessa Hospital Hasselt Belgium, Hasselt University, Hasselt, Belgium.
¹⁷ Faculty of Medicine and Life Sciences Diepenbeek Belgium, University of Antwerp, Antwerp, Belgium.
¹⁸ Faculty of Medicine and Health Sciences Antwerp Belgium, Antwerp University Hospital, Edegem, Belgium.
¹⁹ Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy.
²⁰ Department of Family Medicine, Wroclaw Medical University, Wroclaw, Poland.
²¹ Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
²² German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany.
²³ Institute of Clinical Chemistry & Department of Cardiology, Heart Center, University & University Hospital Zurich, Zurich, Switzerland.
²⁴ Department of Psychology, University of Southern Denmark, Odense, Denmark.
²⁵ Department of Cardiology, Odense University Hospital, Odense, Denmark.
²⁶ Vienna, Austria.
²⁷ Heart Transplantation Outpatient Department, Cardiopulmonary Exercise Test Research Department, Almazov National Medical Research Centre, St. Petersburg, Russia.
²⁸ Department of Psychology, University of Milan-Bicocca, Milano, Italy.
²⁹ School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.
³⁰ Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland.
³¹ Department of Cardiology of Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Institute of Preventive Medicine and Institute of Environmental Health of the Faculty of Medicine of University of Lisbon, Centre of Cardiovascular Investigation of University of Lisbon (CCUL) and Academic Centre of Medicine of University of Lisbon (CAML), Lisbon, Portugal.

PMID: 36098041
DOI: 10.1093/eurjpc/zwac204

Abstract

A key factor to successful secondary prevention of cardiovascular disease (CVD) is optimal patient adherence to treatment. However, unsatisfactory rates of adherence to treatment for CVD risk factors and CVD have been observed consistently over the last few decades. Hence, achieving optimal adherence to lifestyle measures and guideline-directed medical therapy in secondary prevention and rehabilitation is a great challenge to many healthcare professionals. Therefore, in this European Association of Preventive Cardiology clinical consensus document, a modern reappraisal of the adherence to optimal treatment is provided, together with simple, practical, and feasible suggestions to achieve this goal in the clinical setting, focusing on evidence-based concepts.

Keywords: Adherence; Cardiovascular disease; Cardiovascular risk; Secondary prevention.

MeSH terms

Cardiology*
Cardiovascular Diseases* / diagnosis
Cardiovascular Diseases* / epidemiology
Cardiovascular Diseases* / prevention & control
Humans
Life Style
Patient Compliance
Secondary Prevention