{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T06:51:54Z","timestamp":1793170314051,"version":"4.5.0"},"reference-count":55,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Medication adherence (MA) is essential for achieving the benefits of guideline-directed medical therapy in heart failure, yet it is seldom assessed systematically in routine care. Understanding how patients experience and manage long-term medication use in everyday life is critical for designing effective, patient-centered MA support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>A qualitative study explored the experiences of patients with heart failure of factors influencing MA. Data were derived from 4 focus groups and 12 in-depth interviews with 27 participants (May 2022\u2013November 2023) recruited from the Icelandic Heart Failure Registry and a cardiac rehabilitation program. Data were analyzed using inductive thematic analysis, supported by field notes and multidisciplinary review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Four interdependent themes emerged: (1) practical aspects of medication use, including daily routines, dose timing, MA aids, formulation challenges, and polypharmacy; (2) psychosocial influences, such as stress, mood, cognition, social support, and socioeconomic context; (3) interactions with the health care system and providers, including education, follow-up, access, costs, patient-provider relationships, and home support; and (4) disease- and medication-related factors, including symptoms, physical limitations, diuretic burden, and side effects. MA was most consistent when regimens aligned with daily life and when tolerability, follow-up, psychosocial needs, and costs were addressed proactively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Patients with heart failure experience MA as a dynamic process of integrating treatment into daily life rather than a matter of motivation alone. Effective MA support requires regimen simplification, explicit diuretic planning, psychosocial and cost screening, and coordinated multidisciplinary follow-up, including pharmacist involvement. These findings provide patient-derived evidence to inform heart failure\u2013specific MA assessment in routine clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circheartfailure.125.014133","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T06:30:11Z","timestamp":1778481011000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Exploring Medication Adherence in Heart Failure From a Patient Perspective: A Qualitative Study"],"prefix":"10.1161","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9048-4207","authenticated-orcid":true,"given":"Ingibjorg","family":"Gunnthorsdottir","sequence":"first","affiliation":[{"name":"Department of Cardiology (I.G., K.A., E.S., I.J.I.), Landsp\u00edtali - The National University Hospital of Iceland, Reykjav\u00edk, Iceland."},{"name":"Department of Clinical Pharmacy Services (I.G., A.I.G.), Landsp\u00edtali - The National University Hospital of Iceland, Reykjav\u00edk, Iceland."},{"name":"Faculty of Medicine, School of Health Sciences (I.G., K.A., I.J.I.), University of Iceland, Reykjav\u00edk."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna I.","family":"Gunnarsdottir","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy Services (I.G., A.I.G.), Landsp\u00edtali - The National University Hospital of Iceland, Reykjav\u00edk, Iceland."},{"name":"Department of Nephrology (A.I.G.), Landsp\u00edtali - The National University Hospital of Iceland, Reykjav\u00edk, Iceland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5473-7794","authenticated-orcid":true,"given":"Karl","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Cardiology (I.G., K.A., E.S., I.J.I.), Landsp\u00edtali - The National University Hospital of Iceland, Reykjav\u00edk, Iceland."},{"name":"Faculty of Medicine, School of Health Sciences (I.G., K.A., I.J.I.), University of Iceland, Reykjav\u00edk."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6783-3195","authenticated-orcid":true,"given":"Erla","family":"Svansdottir","sequence":"additional","affiliation":[{"name":"Department of Cardiology (I.G., K.A., E.S., I.J.I.), Landsp\u00edtali - The National University Hospital of Iceland, Reykjav\u00edk, Iceland."},{"name":"Department of Psychiatry (E.S.), Landsp\u00edtali - The National University Hospital of Iceland, Reykjav\u00edk, Iceland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inga S.","family":"Thrainsdottir","sequence":"additional","affiliation":[{"name":"Department of Cardiac Rehabilitation, Reykjalundur Rehabilitation Center, Mosfellsb\u00e6r, Iceland (I.S.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3804-6795","authenticated-orcid":true,"given":"Paul","family":"Forsyth","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Golden Jubilee National Hospital, Clydebank, United Kingdom (P.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2474-0815","authenticated-orcid":true,"given":"Inga J\u00f3na","family":"Ingimarsdottir","sequence":"additional","affiliation":[{"name":"Department of Cardiology (I.G., K.A., E.S., I.J.I.), Landsp\u00edtali - The National University Hospital of Iceland, Reykjav\u00edk, Iceland."},{"name":"Faculty of Medicine, School of Health Sciences (I.G., K.A., I.J.I.), University of Iceland, Reykjav\u00edk."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5354-2976","authenticated-orcid":true,"given":"Anna Birna","family":"Almarsdottir","sequence":"additional","affiliation":[{"name":"Faculty of Pharmaceutical Sciences, School of Health Sciences (A.B.A.), University of Iceland, Reykjav\u00edk."},{"name":"Department of Pharmacy, University of Copenhagen, Denmark (A.B.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1858"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvac013"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab368"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)02076-1"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2023.4553"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.115.002606"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.14206"},{"key":"e_1_3_3_9_2","first-page":"1","volume-title":"Adherence to Long-Term Therapies: Evidence for Action","author":"World Health Organization","year":"2003","unstructured":"World Health Organization. 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