Adherence to drug therapy in patients with heart failure associated with reduced ejection fractions (HFrEF) during cardiac rehabilitation and after 3 and 6 months.

INTRODUCTION: Heart failure represents a major challenge for healthcare systems worldwide. Rehabilitation is recommended as an important pillar of therapy for these patients, especially for those with reduced left ventricular ejection fraction (HFrEF: heart failure with reduced ejection fraction). METHODS: The data collected in this multi-center project provide information on the rates of patients with HFrEF who were treated in five German rehabilitation facilities and whether the patients adhered to drug therapy at 3-/6-month follow-up. The project was supported by an unrestricted grant from Novartis-Pharma-GmbH. RESULTS: The mean age of the 234 patients included was 63.4 ± 10.6 years and 78% were male. The mean LVEF was 31 ± 8% at admission and 36 ± 10% at discharge. Only 20.6% of the patients were assigned to rehabilitation with the main indication HF. The most frequent main indication was acute coronary syndrome (46.6%). A high proportion of patients was already on the recommended drug therapy upon admission (94% beta blockers, 100% angiotensin-effective drugs, 70% mineralocorticoid receptor antagonists, etc.). This was optimized, in particular by a higher proportion of patients treated with sodium-glucose cotransporter-2 inhibitors (35% admission vs. 45% discharge) and sacubitril/valsartan (49% admission vs. 64% discharge), which was further optimized during the 6-month follow-up (e.g., 50% SGLT2 inhibitors, 67% sacubitril/valsartan). DISCUSSION: These data illustrate the effect of rehabilitation in terms of optimizing drug therapy, which stabilized over the course of 6 months. Furthermore, only a few patients with the main diagnosis HFrEF are referred for cardiac rehabilitation, although it is an essential part of guideline-based therapy.

Evaluation of medical students' knowledge of psychoactive substances in the context of their future role in addiction prevention and therapy.

This study assesses the knowledge of medical students on the health effects of the use of psychoactive substances, in the context of their future role in prevention and treatment of addictions. The study was conducted using a questionnaire containing questions about classification, symptoms and effects of psychoactive substances, and the existing prevention programs. The study involved 430 students of medicine and allied faculties. Only 20.8% of medicine students and 12.5% of students of other faculties could correctly classify different psychoactive substances. Correct symptoms of drug misuse were mentioned by 20.4% of medicine students and 19.2% of students of other faculties. The overall knowledge of medical students was no greater than the knowledge of students of other allied faculties. Medical students showed insufficient knowledge about psychoactive substances and their effects on the human body, thus indicating the need to introduce into their study programme a more teaching in this area.