Perceived medication adverse effects and coping strategies reported by chronic heart failure patients

Abstract

SUMMARY Background: Data on medication adverse effects (AEs) in chronic heart failure (CHF) are primarily based on results from clinical trials. Little is known about AEs perceived by CHF patients in daily practice and how patients deal with these sub- jective AEs. Aims: To describe the scope and nature of perceived AEs of CHF patients, their coping strategies and the relationship of perceived AEs to medica- tion, patient characteristics and quality of life. Methods: This cross-sectional observational study included a sample of 680 patients previously hospitalised for CHF. Perceived AEs and coping strategies were collected by interviews based on a structured questionnaire. Medication and clinical information were collected by chart review. Results: Of the 670 CHF patients completing the questionnaire, 17% reported at least one AE. In total, 186 AEs were reported of which 15% could not be linked to any medication. Nausea (4%), dizziness (4%), itches (3%) and rash (3%) were the most prevalent. The drug associated with the highest AE rate was pravastatin (27%). On average, more than five different drugs could be related to the AEs headache, dizziness and nausea. Patients reporting AEs had a lower general health perception, younger age and were more often using antiar- rhythmic drugs. Of patients experiencing AEs, 69% conferred with their doctor, 24% reported having done nothing in reaction and 2% discontinued their medica- tion without discussing it with the doctor. Conclusion: Adverse effects are fre- quently perceived by CHF patients, but they are difficult to recognise and manage in daily practice. What's known • Data on drug safety are primarily based on the results from clinical trials, where the patients included often have less comorbidity and comedication than the patients using the drugs in everyday practice. • It has been estimated that at least 5-10% of patients in clinical trials discontinue use of placebo because of perceived adverse effects (AEs).