A qualitative study of chronic heart failure patients' understanding of their symptoms and drug therapy

Objectives: To explore patients' understanding of their symptoms and the treatment of their heart failure. Design: Qualitative analysis of in-depth interviews, using a constant comparative approach. Subjects: 27 patients identified by Cardiology and Care of the Elderly physicians as having (a) symptomatic heart failure (New York Heart Association functional classes 11, Ill and IV) and (b) a hospital admission for heart failure in the previous 20 months. Results: Patients were aged between 38-94 years (mean 69), 20 were in NYHA functional class III or IV. All had at least one concurrent illness. Analysis of the data identified four key areas: patients had little understanding of the purpose of their medications, were concerned about both the quantity and combination of drugs they were prescribed, had difficulties in differentiating between the side effects of drugs and symptoms of heart failure, and had little knowledge to help them interpret and/or treat changing symptoms. Conclusion: Providing patients with relevant information about their medications may help to reduce anxiety about the drugs they are taking. Acknowledging the symptoms associated with heart failure and the likely side effects of treatments might improve patients' ability to interpret, treat or relieve symptoms. (C) 2002 European Society of Cardiology. Published by Elsevier Science B.V. All rights reserved.