OBJECTIVES: Patients with heart disease require long-term treatment and clinical supervision to successfully manage their condition. However, treatment programs are not consistently followed by patients, which compromises their health and long-term outcomes. Non-adherence can be driven by a multitude of intentional (e.g., beliefs) or un-intentional (e.g., forgetfulness) factors. This review explores the prevalence of unintentional non-adherence among patients with heart disease and identifies patients’ needs in terms of addressing unintentional non-adherence to treatment of heart disease.

METHODS: PubMed database was searched using the following search terms: ‘unintentional’ and ‘non-adherence’ and ‘treatment’ and ‘failure’ and ‘heart’. Ten articles were listed and out of these, 5 articles were found relevant. The studies were examined in terms of type of generated evidence describing the characteristics of unintentional non-adherence in this patient population.

RESULTS: Unintentional non-adherence is common among patients with heart disease with patients reporting unintentional reasons (>80%), such as forgetfulness, more frequently than those intentional. Other patient - reported sources of unintentional non-adherence were associated with the lack of access to medication or poor communication with clinicians, leading to confusion with requirements. There is a need to focus on addressing long-term unintentional non-adherence within the first 6 months after discharge as it has been observed to increase 3.5 times during this period.

CONCLUSIONS: This scoping review emphasizes the high prevalence of unintentional non-adherence among patients with heart disease. This highlights the need and opportunity for implementation of patient-centric interventions to help patients establish long-term behavioral habits which may require clearer communication from healthcare providers to patients. Some cross-cultural differences need to be accounted for in countries where patients need to cover the cost of medication. Therefore, specific assessment and interventions must take precedence for patients with limited economic resources in those countries.