'Can I come off the tablets now?' A qualitative analysis of heart failure patients' understanding of their medication.

Objective: To examine whether heart failure patients' awareness of the purpose and side effects of their medicines equips them to participate in informed discussions about treatments.

Design: Qualitative interviews using a maximum variation sample were collected. Interviews were analysed using constant comparison.

Setting: Patients were interviewed throughout the UK, in 2003. Participants. Thirty-seven men and women with heart failure aged between 35 and 85 years.

Results: All groups understood that medication was important and had developed methods (dosette boxes, alarm clocks) to cope. Three levels of awareness were identified. People at Level 1 did not know the purpose or possible side effects of their medication; those at Level 2 knew the names and main side effects and relied on doctors to provide detailed information. People at Level 3 understood their diagnosis and were committed to finding out about their illness.

Conclusion: Knowledge is not the only barrier to informed discussions of heart failure. Although everyone we interviewed knew that they should adhere to their medication regimes, only patients at Level 3 were equipped to discuss their treatment in detail. Patients need to be familiar with symptoms of heart failure, the purpose and side effects of their drugs. Medication reviews and specialist heart failure nurses offer opportunities to improve patients' understanding.