Adherence to the therapy of patients with Heart Failure and Diabetes Mellitus: A Systematic Review
Main Article Content
Abstract
A comorbidity like diabetes mellitus (DM) complicates heart failure (HF) self-care management and adherence to the therapy and results poorer clinical outcomes. This study aims to examine the various factors influencing adherence to the therapy of patients with HF and DM. A systematic literature search was established in the electronic data basis PubMed, Cochrane Library and Cumulative Index to Nursing and Allied Health Literature (CINAHL) using inclusion and exclusion criteria. The search yielded eight articles. The introduction of empowerment models in the management of patients with HF and DM made patients more involved in their self-care management and their self-monitoring behavior and adherence were increased. Patients with HF and DM during their hospitalization, were less likely to receive smoking cessation counseling and blood pressure control and experienced longer length of stay. Patients with HF preserved ejection fraction (HFpEF) and DM were less likely to receive an angiotensin convertive enzyme (ACE) inhibitor or angiotensin receptor or beta-blockers and had worse blood pressure (BP) control compared with patients with reduced ejection fraction (HFrEF) and DM. Effective self-care management of patients with HF and DM seems to depend on the type and the severity of comorbid conditions and the availability of effective therapies. Adequate support to patients with HF and DM from health professionals (HPs) is important, in order to establish self-management and adherence to the therapy.
Keywords:
adherence to therapy, comorbidity, diabetes mellitus, heart failure
Article Details
How to Cite
PHILIPPOU, Katerini et al.
Adherence to the therapy of patients with Heart Failure and Diabetes Mellitus: A Systematic Review.
Medical Research Archives, [S.l.], v. 11, n. 12, jan. 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4585>. Date accessed: 22 dec. 2024.
doi: https://doi.org/10.18103/mra.v11i12.4585.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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2. Rybacki J. Improving cardiovascular health in postmenopausal women by addressing medication adherence issues. Journal of the American Pharmaceutical Association. 2002; 42: 63-71.
3. Rand C. Measuring adherence with therapy for chronic diseases: implications for the treatment of heterozygous familial hypercholesterolemia. American Journal of Cardiology. 1993; 72: 68D-74D.
4. Seferović PM, Petrie MC, Filippatos GS , et al. Type 2 diabetes mellitus and heart failure: a position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail.2018; 20(5): 853-872.
5. 5 Stratton I, Adler A, Neil H. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000; 321:
6. ( 7258), 405-412.
7. Adams K, Fonarow G, Emerman C, et al. Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE). American Heart Journal 2005; 149(2): 209–216. [PubMed: 15846257].
8. Greenberg B, Abraham W, Albert N, et al. Influence of diabetes on Characteristics and outcomes in patients hospitalized with heart failure: a report from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF). American Heart Journal. 2007; 154277 (2): e271–278.
9. Sarma S, Mentz R, Kwasny M. Association between diabetes mellitus and post-discharge outcomes in patients hospitalized with heart failure: findings from the EVEREST trial. European Journal of Heart Failure. 2013; Feb 15(2): 194–202.
10. McEntee, M, Cuomo, L, Dennison C. Patient-provider and system-level barriers to heart failure care. J Cardiovasc Nurs.2009; 24:290-8.
11. Lambrinou E, Protopapas A, Kalogirou F. Educational challenges to the health care professional in heart failure care. Current Heart Failure Reports. 2014; 11(3): 299-306.
12. Lambrinou E, Protopapas, A, Kalogirou F. Heart failure: A challenging syndrome for health care professionals. Cardiovasc Disord Med. 2018; 3(3): 1-5.
13. Cha E, Clark P, Reilly C, et al. Educational Needs for Improving Self-Care in Heart Failure Patients With Diabetes. Diabetes Educator. 2012; 38(5): 673–84. [PubMed: 22722611].
14. Dickson V, Buck H, Riegel B. Multiple comorbid conditions challenge heart failure self-care by decreasing self-efficacy. Nursing Research. 2013; 62(1): 2–9. [PubMed: 23052421].
15. Wu S, Huang Y, Lee M, Wang T, Tung H, Wu M. Self-efficacy, self-care behavior, anxiety, and depression in Taiwanese with type 2 diabetes: A cross-sectional survey [Epub ahead of print]. Nursing and Health Science. 2013; doi: 10.1111/nhs.1202.
16. Krumholz H, Currie P, Riegel B, Philips C, Peterson E, Smith R. A taxonomy for disease management: a scientific statement from the American Heart Association Disease Management Taxonomy Writing Group. Circulation 2006; 114: 1432-45.
17. Ekundayo O, Muchimba M, Aban I, Ritchie C, Campell R, Ahmed A. Multimorbidity due to diabetes mellitus and chronic kidney disease and outcomes in chronic heart failure. Am J Cardiology. 2009; 103: 88-92.
18. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China : A descriptive study. Lancet. 2020; 395 (10223):507-13.
19. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395 (10223): 497-506.
20. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, et al. ESC Scientific Document Group. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J., 2021; 27: ehab368. doi: 10.1093/eurheartj/ehab368.
21. Rector T. A conceptual model of quality of life in relation to heart failure, J Card Fail. 2005; 11: 173-6.
22. Riegel B, Dickson V. A situation-specific theory of heart failure self-care, J Cardiovasc Nurs. 2008; 23 (3): 190-6.
23. Lainscak M, Blue L, Clark A, Dahlstrom U, Dickstein K, Ekman I. Self-care management of heart failure: practical recommendations from the Patient Care Committee of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2011; 13: 115-26.
24. Piette, J, Kerr E. The impact of comorbid chronic conditions on diabetes care. Diabetes Care, 2006; 29 (3): 725–731. [PubMed: 16505540].
25. Kerr E, Heisler M, Krein S, et al. Beyond comorbidity counts: how do comorbidity type and severity influence diabetes patients' treatment priorities and self-management? Journal of General Internal Medicine, 2007; 22 (12): 1635–1640. [PubMed: 17647065].
26. Effective Public Health Practice Project (EPHPP). Dictionary for the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies, Retrieved October 2008 from above web address. Corresponding article of interest: Thomas B.H, Ciliska, D, Dobbins M. & Micucci S. (2004). A process for systematically reviewing the literature: Providing the research evidence for public health nursing interventions. Worldviews on Evidence-Based Nursing 1998; 1 (3): 176-184.
27. Thomas B.H, Ciliska D, Dobbins M, Micucci S. A process for systematically reviewing the literature: Providing the research evidence for public health nursing interventions. Worldviews on Evidence-Based Nursing. 2004; 1 (3): 176-184.
28. Ciccone M, Aquilino, A, Cortese F, et al.Feasibility and effectiveness of a disease and care management model in the primary health care system for patients with heart failure and diabetes (Project Leonardo). Vascular Health and Risk Management. 2010; 6:297-305.
29. Edelmann F, Wachter R, Dungen H, et al. The German Competence Network Heart Failure-Heart failure therapy in diabetic patients-comparison with the recent ESC/EASD guideline. Cardiovascular Diabetology. 2011; 10:15.
30. Kapoor J, Fonarow G, Zhao X, Kapoor R, Hernandez A, Heidenreich P. Diabetes, quality of care, and in-hospital outcomes in patients hospitalized with heart failure. American Heart Journal. 2011; 162(3): 480-486.
31. Dunbar S, Reilly C, Gary R, Higgins M, Culler S, Butts B, Butler J. Randomized Clinical Trial of an Integrated Self-care Intervention for Persons with Heart Failure and Diabetes: Quality of Life and Physical Functioning Outcomes. J Card Fail. 2015; 21 (9): 719-729. Doi: 10.1016/j.cardfail.2015.05.012.
32. Peres H, Alves P, Leonardo R, Leira M, Edson Z, Viana CM, Foss-Freitas, MC. HEART failure is associated with non-adherence to pharmacotherapy in elderly with type 2 diabetes mellitus in public health system Brazilians. Diabetes & Metabolic Syndrome: Research & Reviews 2019; 13: 939-946.
33. Rose L, et al. The contexts of adherence for African Americans with high blood pressure. Journal of Advanced Nursing. 2000; 32: 587-594.
34. Mola E, DeBonis J, Giancane R. Integrating patient empowerment as an essential characteristic of the discipline of general practice/family medicine. Eur J Gen Pract. 2008; 26:1–6.
35. Lambrinou E, Hansen T, Beulens J. Lifestyle factors, self-management and patient empowerment in diabetes care. European Journal of Preventive Cardiology. 2019; https://doi.org/10.1177/2047487319885455.
36. Carpenter R, Di Chiacchio T, Barker K. Interventions for self-management of type 2 diabetes: An integrative review. Int J Nurs Sci, 2019; 6: 70–91
37. Riegel B, Moser D, Anker S; Appel L, Dunba S, Grady K. State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association. Circulation 2009; 120: 1141-63.
38. 37. Poudel N, Kavookjian J, Scalese M. Motivational Interviewing as a Strategy to Impact Outcomes in Heart Failure Patients: A Systematic Review. The Patient-Centered Outcomes Research 2020; 13: 43–55.
39. Ekman, I, Wallstrom S. Person-centered care in clinical assessment. European Journal of Cardiovascular Nursing. 2018; 17: 576-579.
40. 39. Ghizzardi G, Arrigoni C, Dellafiore F, Vellone E, Caruso R. Efficacy of motivational interviewing on enhancing self-care behaviors among patients with chronic heart failure: a systematic review and meta-analysis of randomized controlled trials, Heart Failure Reviews 2022; 27: 1029–1041.
41. Rubin R. Adherence to pharmacologic therapy in patients with type 2 diabetes mellitus. Am J, 2005; 118: Suppl 5A, 27S–34S.
42. Kyriakou M, Samara A, Philippou K, Lakatamitou I, Lambrinou E. A qualitative meta-synthesis of patients with heart failure perceived needs. Reviews in Cardiovascular Medicine. 2021; 22(3): 853-864.
43. Granata A, Hillman A. Competing practice guidelines: using cost-effectiveness analysis to make optimal decisions. Ann Intern Med., 2008; 1: 128(1), 56-63.
44. Lamothe L, Paquette M, Fortin J, Labbe F, Messikh D, Duplantie J. The use of tele homecare for better monitoring of chronic diseases. Sante Publique. 2013; 25(2): 203-11.
45. Brahmbhatt D, Cowie M. Remote Management of Heart Failure: An Overview of Telemonitoring Technologies. Card Fail Rev., 2019; 5(2): 86–92.
46. Kyriakou M, Middleton N, Ktisti S, Philippou K, Lambrinou E. Supportive Care Interventions to Promote Health-Related Quality of Life in Patients Living With Heart Failure: A Systematic Review and Meta-Analysis. Heart Lung Circ., 2020; 29(11): 1633-1647.
47. Lorig K, Sobel D, Gonzalez V, Minor M. Living a Healthy life with Chronic Conditions: Self-management of Heart Disease, Arthritis, Diabetes, Asthma, Bronchitis, Emphysema and others. 2006; Boulder, CO: Bull Publishing.
48. Baptista DR, Thieme RD, Reis WCT, Pontarolo R, Correr CJ. Proportion of Brazilian diabetes patients that achieve treatment goals: implications for better quality of care. Diabetol Metab Syndrome. 2015; 7(1): 113.
49. Seabury S, Lakdawalla D, Dougherty S, Sullivan J, Goldman D. Medication Adherence and Measures of Health Plan Quality. The American Journal of Managed Care. 2015; 21(6): 379-389.
50. Aktaa S, Polovina M,Rosano G, Abdin A, Anguita M. European Society of Cardiology quality indicators for the care and outcomes of adults with heart failure. Developed by the Working Group for Heart Failure Quality Indicators in collaboration with the Heart Failure Association of the European Society of Cardiology. European Journal of Heart Failure. 2022; 24: 132-142,doi:10.1002/ejhf.2371.
51. WHO, Adherence to long-term therapies-evidence for action. WHO Library: Cataloguing-in Publication Data; 2003.
52. Paradis V, Cossette S, Frasure-Smith N, Heppell S. The Efficacy of a Motivational Nursing Intervention Based on the Stages of Change on Self-care in Heart Failure. Journal of Cardiovascular Nursing. 2010; 25 (2): 130Y141.
53. Jessup M, Loh E. Heart Failure, A Clinician’s Guide to Ambulatory Diagnosis and Treatment Contemporary Cardiology. Humana Press; 2003.
54. Riegel B, Carson B, Moser D, Sebern M. Hicks F. Roland Psychometric testing of the self-care of heart failure index. Cardiac Fail, 2004; 10: 350-60.
55. Norris, S, Engelgau, M, Narayan K. Effectiveness of Self – Management Training in Type 2 Diabetes. Diabetes Care 2001; 24 (3): 561-587.
56. Dunbar S, Butts B, Reilly C, Gary R, Higgins M, Ferranti E, Culler S, Butler J. A pilot test of an integrated self-care intervention for persons with Heart Failure and concomitant Diabetes. Nurs Outlook. 2014; 62 (2): 97-111.doi:10.1016/j.outlook.2013.09.003.
2. Rybacki J. Improving cardiovascular health in postmenopausal women by addressing medication adherence issues. Journal of the American Pharmaceutical Association. 2002; 42: 63-71.
3. Rand C. Measuring adherence with therapy for chronic diseases: implications for the treatment of heterozygous familial hypercholesterolemia. American Journal of Cardiology. 1993; 72: 68D-74D.
4. Seferović PM, Petrie MC, Filippatos GS , et al. Type 2 diabetes mellitus and heart failure: a position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail.2018; 20(5): 853-872.
5. 5 Stratton I, Adler A, Neil H. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000; 321:
6. ( 7258), 405-412.
7. Adams K, Fonarow G, Emerman C, et al. Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE). American Heart Journal 2005; 149(2): 209–216. [PubMed: 15846257].
8. Greenberg B, Abraham W, Albert N, et al. Influence of diabetes on Characteristics and outcomes in patients hospitalized with heart failure: a report from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF). American Heart Journal. 2007; 154277 (2): e271–278.
9. Sarma S, Mentz R, Kwasny M. Association between diabetes mellitus and post-discharge outcomes in patients hospitalized with heart failure: findings from the EVEREST trial. European Journal of Heart Failure. 2013; Feb 15(2): 194–202.
10. McEntee, M, Cuomo, L, Dennison C. Patient-provider and system-level barriers to heart failure care. J Cardiovasc Nurs.2009; 24:290-8.
11. Lambrinou E, Protopapas A, Kalogirou F. Educational challenges to the health care professional in heart failure care. Current Heart Failure Reports. 2014; 11(3): 299-306.
12. Lambrinou E, Protopapas, A, Kalogirou F. Heart failure: A challenging syndrome for health care professionals. Cardiovasc Disord Med. 2018; 3(3): 1-5.
13. Cha E, Clark P, Reilly C, et al. Educational Needs for Improving Self-Care in Heart Failure Patients With Diabetes. Diabetes Educator. 2012; 38(5): 673–84. [PubMed: 22722611].
14. Dickson V, Buck H, Riegel B. Multiple comorbid conditions challenge heart failure self-care by decreasing self-efficacy. Nursing Research. 2013; 62(1): 2–9. [PubMed: 23052421].
15. Wu S, Huang Y, Lee M, Wang T, Tung H, Wu M. Self-efficacy, self-care behavior, anxiety, and depression in Taiwanese with type 2 diabetes: A cross-sectional survey [Epub ahead of print]. Nursing and Health Science. 2013; doi: 10.1111/nhs.1202.
16. Krumholz H, Currie P, Riegel B, Philips C, Peterson E, Smith R. A taxonomy for disease management: a scientific statement from the American Heart Association Disease Management Taxonomy Writing Group. Circulation 2006; 114: 1432-45.
17. Ekundayo O, Muchimba M, Aban I, Ritchie C, Campell R, Ahmed A. Multimorbidity due to diabetes mellitus and chronic kidney disease and outcomes in chronic heart failure. Am J Cardiology. 2009; 103: 88-92.
18. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China : A descriptive study. Lancet. 2020; 395 (10223):507-13.
19. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395 (10223): 497-506.
20. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, et al. ESC Scientific Document Group. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J., 2021; 27: ehab368. doi: 10.1093/eurheartj/ehab368.
21. Rector T. A conceptual model of quality of life in relation to heart failure, J Card Fail. 2005; 11: 173-6.
22. Riegel B, Dickson V. A situation-specific theory of heart failure self-care, J Cardiovasc Nurs. 2008; 23 (3): 190-6.
23. Lainscak M, Blue L, Clark A, Dahlstrom U, Dickstein K, Ekman I. Self-care management of heart failure: practical recommendations from the Patient Care Committee of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2011; 13: 115-26.
24. Piette, J, Kerr E. The impact of comorbid chronic conditions on diabetes care. Diabetes Care, 2006; 29 (3): 725–731. [PubMed: 16505540].
25. Kerr E, Heisler M, Krein S, et al. Beyond comorbidity counts: how do comorbidity type and severity influence diabetes patients' treatment priorities and self-management? Journal of General Internal Medicine, 2007; 22 (12): 1635–1640. [PubMed: 17647065].
26. Effective Public Health Practice Project (EPHPP). Dictionary for the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies, Retrieved October 2008 from above web address. Corresponding article of interest: Thomas B.H, Ciliska, D, Dobbins M. & Micucci S. (2004). A process for systematically reviewing the literature: Providing the research evidence for public health nursing interventions. Worldviews on Evidence-Based Nursing 1998; 1 (3): 176-184.
27. Thomas B.H, Ciliska D, Dobbins M, Micucci S. A process for systematically reviewing the literature: Providing the research evidence for public health nursing interventions. Worldviews on Evidence-Based Nursing. 2004; 1 (3): 176-184.
28. Ciccone M, Aquilino, A, Cortese F, et al.Feasibility and effectiveness of a disease and care management model in the primary health care system for patients with heart failure and diabetes (Project Leonardo). Vascular Health and Risk Management. 2010; 6:297-305.
29. Edelmann F, Wachter R, Dungen H, et al. The German Competence Network Heart Failure-Heart failure therapy in diabetic patients-comparison with the recent ESC/EASD guideline. Cardiovascular Diabetology. 2011; 10:15.
30. Kapoor J, Fonarow G, Zhao X, Kapoor R, Hernandez A, Heidenreich P. Diabetes, quality of care, and in-hospital outcomes in patients hospitalized with heart failure. American Heart Journal. 2011; 162(3): 480-486.
31. Dunbar S, Reilly C, Gary R, Higgins M, Culler S, Butts B, Butler J. Randomized Clinical Trial of an Integrated Self-care Intervention for Persons with Heart Failure and Diabetes: Quality of Life and Physical Functioning Outcomes. J Card Fail. 2015; 21 (9): 719-729. Doi: 10.1016/j.cardfail.2015.05.012.
32. Peres H, Alves P, Leonardo R, Leira M, Edson Z, Viana CM, Foss-Freitas, MC. HEART failure is associated with non-adherence to pharmacotherapy in elderly with type 2 diabetes mellitus in public health system Brazilians. Diabetes & Metabolic Syndrome: Research & Reviews 2019; 13: 939-946.
33. Rose L, et al. The contexts of adherence for African Americans with high blood pressure. Journal of Advanced Nursing. 2000; 32: 587-594.
34. Mola E, DeBonis J, Giancane R. Integrating patient empowerment as an essential characteristic of the discipline of general practice/family medicine. Eur J Gen Pract. 2008; 26:1–6.
35. Lambrinou E, Hansen T, Beulens J. Lifestyle factors, self-management and patient empowerment in diabetes care. European Journal of Preventive Cardiology. 2019; https://doi.org/10.1177/2047487319885455.
36. Carpenter R, Di Chiacchio T, Barker K. Interventions for self-management of type 2 diabetes: An integrative review. Int J Nurs Sci, 2019; 6: 70–91
37. Riegel B, Moser D, Anker S; Appel L, Dunba S, Grady K. State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association. Circulation 2009; 120: 1141-63.
38. 37. Poudel N, Kavookjian J, Scalese M. Motivational Interviewing as a Strategy to Impact Outcomes in Heart Failure Patients: A Systematic Review. The Patient-Centered Outcomes Research 2020; 13: 43–55.
39. Ekman, I, Wallstrom S. Person-centered care in clinical assessment. European Journal of Cardiovascular Nursing. 2018; 17: 576-579.
40. 39. Ghizzardi G, Arrigoni C, Dellafiore F, Vellone E, Caruso R. Efficacy of motivational interviewing on enhancing self-care behaviors among patients with chronic heart failure: a systematic review and meta-analysis of randomized controlled trials, Heart Failure Reviews 2022; 27: 1029–1041.
41. Rubin R. Adherence to pharmacologic therapy in patients with type 2 diabetes mellitus. Am J, 2005; 118: Suppl 5A, 27S–34S.
42. Kyriakou M, Samara A, Philippou K, Lakatamitou I, Lambrinou E. A qualitative meta-synthesis of patients with heart failure perceived needs. Reviews in Cardiovascular Medicine. 2021; 22(3): 853-864.
43. Granata A, Hillman A. Competing practice guidelines: using cost-effectiveness analysis to make optimal decisions. Ann Intern Med., 2008; 1: 128(1), 56-63.
44. Lamothe L, Paquette M, Fortin J, Labbe F, Messikh D, Duplantie J. The use of tele homecare for better monitoring of chronic diseases. Sante Publique. 2013; 25(2): 203-11.
45. Brahmbhatt D, Cowie M. Remote Management of Heart Failure: An Overview of Telemonitoring Technologies. Card Fail Rev., 2019; 5(2): 86–92.
46. Kyriakou M, Middleton N, Ktisti S, Philippou K, Lambrinou E. Supportive Care Interventions to Promote Health-Related Quality of Life in Patients Living With Heart Failure: A Systematic Review and Meta-Analysis. Heart Lung Circ., 2020; 29(11): 1633-1647.
47. Lorig K, Sobel D, Gonzalez V, Minor M. Living a Healthy life with Chronic Conditions: Self-management of Heart Disease, Arthritis, Diabetes, Asthma, Bronchitis, Emphysema and others. 2006; Boulder, CO: Bull Publishing.
48. Baptista DR, Thieme RD, Reis WCT, Pontarolo R, Correr CJ. Proportion of Brazilian diabetes patients that achieve treatment goals: implications for better quality of care. Diabetol Metab Syndrome. 2015; 7(1): 113.
49. Seabury S, Lakdawalla D, Dougherty S, Sullivan J, Goldman D. Medication Adherence and Measures of Health Plan Quality. The American Journal of Managed Care. 2015; 21(6): 379-389.
50. Aktaa S, Polovina M,Rosano G, Abdin A, Anguita M. European Society of Cardiology quality indicators for the care and outcomes of adults with heart failure. Developed by the Working Group for Heart Failure Quality Indicators in collaboration with the Heart Failure Association of the European Society of Cardiology. European Journal of Heart Failure. 2022; 24: 132-142,doi:10.1002/ejhf.2371.
51. WHO, Adherence to long-term therapies-evidence for action. WHO Library: Cataloguing-in Publication Data; 2003.
52. Paradis V, Cossette S, Frasure-Smith N, Heppell S. The Efficacy of a Motivational Nursing Intervention Based on the Stages of Change on Self-care in Heart Failure. Journal of Cardiovascular Nursing. 2010; 25 (2): 130Y141.
53. Jessup M, Loh E. Heart Failure, A Clinician’s Guide to Ambulatory Diagnosis and Treatment Contemporary Cardiology. Humana Press; 2003.
54. Riegel B, Carson B, Moser D, Sebern M. Hicks F. Roland Psychometric testing of the self-care of heart failure index. Cardiac Fail, 2004; 10: 350-60.
55. Norris, S, Engelgau, M, Narayan K. Effectiveness of Self – Management Training in Type 2 Diabetes. Diabetes Care 2001; 24 (3): 561-587.
56. Dunbar S, Butts B, Reilly C, Gary R, Higgins M, Ferranti E, Culler S, Butler J. A pilot test of an integrated self-care intervention for persons with Heart Failure and concomitant Diabetes. Nurs Outlook. 2014; 62 (2): 97-111.doi:10.1016/j.outlook.2013.09.003.