Adherence to guideline-directed medical treatments in heart failure. A scientific statement of the Heart Failure Association (HFA) of the ESC and the ESC Working Group on Cardiovascular Pharmacotherapy

Heart failure (HF) affects over 60 million individuals globally. Contemporary guideline-directed medical therapies (GDMT) reduce cardiovascular mortality and HF hospitalizations. However, medication non-adherence represents a critical barrier limiting real-world efficacy of GDMT. This scientific statement aims to provide a comprehensive framework for understanding, measuring, and addressing medication non-adherence in HF management across diverse healthcare settings. Addressing medication non-adherence requires systematic, multifaceted approaches targeting individual patient barriers while implementing system-level interventions. Polypills, digital monitoring platforms, enhanced patient education and empowerment, and multidisciplinary care models represent promising strategies to optimize therapeutic adherence and improve clinical outcomes in HF management.