Cardiac Rehabilitation to Optimize Medication Regimens in Heart Failure

Clin Geriatr Med. 2019 Nov;35(4):549-560. doi: 10.1016/j.cger.2019.06.001. Epub 2019 Jun 21.

Abstract

Cardiac rehabilitation (CR) is an inherently patient-centered program that provides holistic care to adults with cardiovascular conditions to promote lifelong health and fitness, facilitate self-care and self-efficacy, and improve clinical outcomes. CR offers an excellent platform for patient-centered optimization of medication regimens for older adults with heart failure through its potential to address several aspects of care that have historically served as major challenges to clinicians-diuretic management, the use of guideline-directed medical therapy, review and reconciliation of noncardiovascular medications, and optimization of medication adherence. In this review, these challenges are described and strategies offered for leveraging CR toward addressing them.

Keywords: Cardiac rehabilitation; Drug therapy; Heart failure; Inappropriate prescribing; Medication adherence.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / administration & dosage
  • Cardiac Rehabilitation / methods*
  • Cardiotonic Agents / administration & dosage
  • Drug Utilization / statistics & numerical data*
  • Female
  • Geriatric Assessment / methods
  • Heart Failure / drug therapy*
  • Heart Failure / mortality
  • Heart Failure / rehabilitation*
  • Humans
  • Male
  • Medication Adherence / statistics & numerical data*
  • Patient-Centered Care / organization & administration
  • Physical Fitness / physiology
  • Polypharmacy
  • Quality of Life*
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • Severity of Illness Index
  • Survival Analysis
  • United States
  • Vasodilator Agents / therapeutic use

Substances

  • Antihypertensive Agents
  • Cardiotonic Agents
  • Vasodilator Agents