What is heart failure? 

Heart failure is a chronic medical condition characterized by the inability of the heart to pump blood effectively to meet the needs of the body. The heart may be unable to fill with enough blood (diastolic heart failure) or pump with enough force (systolic heart failure) or both. As a result, the body may not receive an adequate supply of oxygen-rich blood.  This results in a buildup of fluid in the body, leading to various complications. Usually, the fluid buildup takes place in the lungs and causes swelling over the body. As a result, your body gets deprived of the essential functioning element oxygen, causing shortness of breath and several complications in various organ systems. Timely treatment with medication can help you to prevent the fatality rate in heart failure patients. 

What are the Symptoms of Heart failure?

Heart failure is not a sudden onset. It may develop periodically over time showing some symptoms. Let us identify some of the symptoms of heart failure.

1. Persistent coughing with wheezing.
2. Irregular heartbeat.
3. Physical movements.
4. Develop sudden weight gain due to fluid retention.
5. Loss of appetite.
6. Difficulties in sleeping.
7. Getting Confused or impaired thinking.
8. Frequent urination, especially at night.

What are the types of heart failure? 

1. Left-sided heart failure
2. Right-sided heart failure

Left-sided heart failure: 

1. Systolic failure: Your left ventricle slowly loses its ability to effectively contract and push the blood into circulation. The patients in this condition usually present with reduced ejection fraction
2. Diastolic failure: Your left ventricle is unable to relax because the heart muscles have already stiffened, resulting in incorrect blood filling during the resting phase. 

Right-sided heart failure:

It is usually caused as a result of left-sided heart failure; as the left ventricle is compromised, it transfers the pressure to the lungs, which also puts an additional burden on the right ventricle. After this condition, blood tries to build up in the veins, causing a bulge in the right ventricle.

What are the causes of heart failure? 

Heart failure is a condition that develops due to the narrowing of arteries by the fat and plaque buildup or formation causing atherosclerosis; this further causes cardiovascular conditions such as coronary artery disease, myocardial infarction, hypertension, cardiomyopathy, and various valvular diseases of the heart.

Therapeutic management of heart failure

Some of the various medication treatment options available are:

• Aldosterone antagonist: People with heart failure accumulate fluids because their hearts cannot pump blood as effectively as they should. Aldosterone antagonists aid in the removal of extra fluid from the bodies of those suffering from heart failure. Your heart has an easier time pumping less fluid.
• Beta blockers: Beta blockers are known as blood pressure-lowering or antihypertensive medications. These medications prevent the effects of adrenaline hormones and cause the heart to beat less forcefully and more slowly, lowering blood pressure. They also improve blood flow by relaxing and widening veins and arteries. Medications like bisoprolol are widely employed to treat blood pressure, angina pectoris, and heart failure. 
• ACE Inhibitors: The heart must beat harder due to the angiotensin hormone's effects, which could raise blood pressure. This action causes the narrowing of blood vessels. ACE inhibitors act by relaxing the arteries and veins, which causes reduced blood pressure and reduced load on heart muscles.
• Angiotensin receptor and Neprilysin receptor: Sacubitrivir/valsartan is the newest addition to the traditional combination therapy for heart failure. Azmarda 100mg tablet contains the active compounds Sacubitril and Valsartan, which are helpful in treating chronic heart failure. ARNI will reduce the chance of thrombosis, fibrosis, cardiac myocyte hypertrophy, and renin release while promoting the positive effects on vasodilation of arterial and venous blood vessels that reduce the symptoms of heart failure.
• Cardiac glycosides: Digoxin inhibits the action of Na+/K+ ATPase enzyme that raises intracellular calcium levels and improves heart contraction. It increases the force of heart muscle contraction, and this beneficial inotropic effect alleviates symptoms like exhaustion and dyspnea. Digoxin also lowers heart rate and enhances heart rhythm regulation.

How to Improve Medication Adherence? 

Managing so many medications can frequently become an overwhelming process, making the patient feel ill from taking so many different ones. This can eventually result in medication nonadherence, where the patient skips part or all of the prescribed medications or misses doses. This frequently has the potential to be fatal; thus, providing appropriate patient care and adhering to medication adherence are essential to enhancing patients' quality of life. 

WHO has defined medication adherence as the extent to which an individual's action aligns with healthcare providers' recommendations and course of action. People with heart failure must strictly adhere to their medications as the disease has already reached a stage where it poses as a life-threatening one. 

• The primary cause of medication nonadherence is missing the dose. You can overcome this by using a pill organizer that contains slots for every time of the day and indicates various colors. This will help the patients easily identify and ensure the timely consumption of medicines.
• Explain to the patient the medications they are indicated for, their importance, and their action on the body, rather than simply writing the prescription. Make sure to clear any worries of the patient, including side effects.
• Technological advances have opened the leverage of monitoring adherence using telehealth methods such as arranging virtual visits via calls, medication reminder apps, and remote patient monitoring apps. 
• Another cause of patients' nonadherence is their false beliefs and fear of side effects and the potential harm they may cause. Healthcare providers must address these issues and instill trust in the therapy and its benefits. Sometimes, certain modifications in the frequency of medications and dosage can make a huge difference in medication adherence in patients.
• Healthcare providers can simplify the medication regimen by prescribing combination medications that reduce the need to take multiple pills. 
• Medication adherence can be improved by involving the family and friends of the patient to give a remainder and help them take medicines promptly without fail.

Conclusion

Adhering to certain medication-adherence behaviors can help patients with heart failure better manage their multiple medication intakes and achieve better treatment outcomes. Thus, it significantly lowers hospitalization rates, improves patient satisfaction, and, in the end, lessens the financial strain brought on by the extended stay.