Adherence to Drug Therapy in Patients With HFrEF During Inpatient Rehabilitation and After at 3 and 6-months.

In German cardiac rehabilitation clinics the number of patients with reduced ejection fraction is continuously increasing since years. Approximately 2,000 patients with cardiac diseases were treated per year per clinic and LVEF \< 40% was often found in patients. The mean length of stay in the rehabilitation clinics is 21 days, which gives the chance and the necessity to optimize not only medical therapy. Here, all relevant baseline parameters (indication for rehabilitation, all clinical diagnoses, age, sex, BMI, echocardiographic parameters such as LVEF or diastolic dysfunction, laboratory parameters corresponding to the recording standard of the clinic, etc.) will be recorded in an electronic CRF. Medical treatment is recorded at the drug class level and enquires about the use of the following drug classes: betablockers (BB) (yes/no), angiotensin converting enzyme inhibitors (ACEI) (yes/no), angiotensin receptor blockers (ARB) (yes/no), aldosterone receptor antagonist (yes/no) and diuretics (yes/no). Furthermore, treatment according Guideline ESC 2016 (yes/no) will be recorded in all patients at initial presentation and follow-up as well as if recommended target dose was reached (yes/no). New York Heart Association (NYHA) quantification of heart failure symptoms will be noted. Furthermore, NT-proBNP at baseline and, if available, at discharge, Quality of Life (SF-12), anxiety and depression (HADS-D) will be determined and non-drug therapy including nutrition (minimal nutrition assessment = MNA) (5) and exercise (patient exercise diary) will be investigated during inpatient rehabilitation and follow-up period. After discharge, patients will be contacted by mail after three and twelve months. Here, general questions about drug therapy and dosages, re-hospitalizations especially in connection with HFrEF are recorded in a standardized questionnaire. If postal response cannot be achieved, a telephone contact will be carried out. Drug therapy with special regards to