FUND‑HF: Financial Support Improves Medication Adherence in Vulnerable Patients

A small pilot trial called FUND‑HF, presented at ACC.26 and published in JACC, shows that a one‑time $500 financial payment given soon after hospital discharge significantly improves medication adherence in economically vulnerable patients with heart failure with reduced ejection fraction (HFrEF). 

The randomized, 1:1 study enrolled 153 adults within two weeks of HF hospitalization at Parkland Memorial Hospital in Dallas, all with incomes below 130% of the Federal Poverty Level, difficulty paying bills, and at least one additional social determinant of health (SDOH) risk factor.

Those in the early financial support group received a prepaid ClinCard with no spending restrictions, while the control group received usual care without financial assistance. At one month, mean medication adherence was 0.74 in the financial‑support arm versus 0.54 in controls (p = 0.001); patients with financial support had a 42% higher probability of full adherence and better adherence to key HF guideline‑directed therapies like metoprolol and spironolactone. 

Adherence‑related metrics such as Kansas City Cardiomyopathy Questionnaire scores and all‑cause hospitalization rates did not differ significantly, likely because of the short follow‑up and pilot scale.

The investigators describe FUND‑HF as an “upstream” intervention that directly addresses adverse SDOH during a critical transition period, rather than relying only on traditional health‑system‑based support programs. 

They argue that these findings support larger, longer‑term trials testing whether sustained financial assistance can not only maintain better adherence but also improve quality of life, HF‑related outcomes, and health‑equity metrics in economically vulnerable populations.