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Utility of the implementation of a standardized evaluation program for therapeutic adherence in heart failure

Session Poster Session 2

Speaker Maria Del Carmen Duran Torralba

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure: Lifestyle Modification
  • Session type : Poster Session

Authors : M Duran Torralba (Andujar,ES), G Lopez Moyano (Andujar,ES), C Rus Mansilla (Andujar,ES), G Cortez Quiroga (Andujar,ES), M Santisteban Sanchez De Puerta (Andujar,ES), M Delgado Moreno (Andujar,ES), A Fernandez Suarez (Andujar,ES), D Fatela Cantillo (Andujar,ES)

Authors:
M Duran Torralba1 , G Lopez Moyano1 , C Rus Mansilla1 , G Cortez Quiroga1 , M Santisteban Sanchez De Puerta1 , M Delgado Moreno1 , A Fernandez Suarez1 , D Fatela Cantillo1 , 1Hospital Alto Guadalquivir, Cardiology - Andujar - Spain ,

Citation:

Introduction: The therapeutic adherence in patients with heart failure (HF) is important to avoid readmissions. The Morisky-green test (MG) is one of the most used but has limitations. We designed a health intervention consisting of a standardized assessment of adherence and knowledge of drugs complemented with individual education implemented by nursing in patients with HF. Aims: To assess whether the implementation of a standardized evaluation of therapeutic adherence is more effective than the application of the MG test. Assess whether the knowledge of the drugs and the intervention on it, by nursing, translates into greater therapeutic adherence compared with the conventional approach. 
Methods: The standardized evaluation consists of a first area where compliance is assessed based on what the patient communicates and the verification of the correct intake of drugs and the second area assesses the knowledge of the action of these and the ability to respond to a decompensation through knowledge of the flexible diuretic regimen. With the first area, we identify the patient who complied or not and with the second, we identify the patients who need to reinforce health education due to little or no knowledge of the medication
Results: We included 100 consecutive patients, assessed in the HF Unit at the time of inclusion, included in the period of January 2014 and January 2018. The mean age was 70 ± 13 years, 61% were men, 72% were HFrEF, 18% HFmid-range EF and 10% HFpEF. All patients were first given the MG questionnaire and subsequently the standardized evaluation. According to the MG test, 3 non-compliant patients (3%) were identified. After standardized evaluation, 12 non-compliers (12%) were identified, this difference being significant (p <0.01). In addition, 92 patients (92%) were identified with little knowledge about the drugs and the ability to act in the face of decompensation.
Conclusions: The implementation of the standardized evaluation to asses therapeutic adherence en HF allowed to identify more accurately the non-compliant patients, compared with the MG test. It also presented as an added advantage, the identification of those patients with poor capacity to respond to a decompensation and act early to avoid readmissions

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