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Patient adherence to self-care is an important theme discussed in evidence-based consensus treatment guidelines, although the level of evidence reflects only expert opinion. This article summarizes what is known about self-care from the perspective of healthcare system personnel and healthcare providers. This perspectives of these two groups may influence patients abilities to perform self-care and may sway treatment guideline or performance measure recommendations. No performance measures address patient adherence to any aspect of self-care in the hospital or ambulatory care setting. Likewise, education and demonstration of self-care interventions that might aid patients to adhere to the heart failure plan of care are not systematically applied in healthcare systems or by providers. Thus, we remain unsure if the intervention methods used are effective or if the breadth and depth of education provided are sufficient. This article discusses the current state of clinical practice aimed at promoting patient adherence to self-care and how healthcare systems and healthcare providers contribute to reaching self-care goals.