Treatment adherence in patients with heart failure receiving nurse-assisted home visits

Mantovani, Vanessa Monteiro; Ruschel, Karen Brasil; Souza, Emiliane Nogueira de; Mussi, Claudia; Rabelo-Silva, Eneida Rejane

doi:10.1590/1982-0194201500008

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Acta Paulista de Enfermagem

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Sumário

Original Articles • Acta Paul Enferm. 28 (1) • Jan-Feb 2015 • https://doi.org/10.1590/1982-0194201500008 copy

Treatment adherence in patients with heart failure receiving nurse-assisted home visits

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective

: To assess treatment adherence in patients with heart failure receiving nurse-led home visits after hospital discharge.

Methods

: This was a before-and-after study involving patients who had been recently hospitalized for decompensated heart failure. Three home visits were conducted within 45 days of hospital discharge. Treatment adherence was assessed in the first and third visits through a 10-item questionnaire (cutoff point: 18 = 70% adherence). In the first and second visits, patients were educated as to their condition, treatment adherence and self-care.

Results

: There were 32 patients included, mean age 65±16 years, 18(58%) male. The 32 patients received a total of 96 home visits. Treatment adherence scores were of 16±2.6 vs 20.4±2.7 in the first and third visits, respectively (p=0,001). Weight monitoring and liquid restriction behaviors improved significantly following the intervention.

Conclusion

: The in-home educational intervention led to significant improvements in the treatment adherence of recently-hospitalized patients with heart failure.

Patient compliance; Nursing care; Nursing; practical; Heart failure; Home visit

Characteristics	Media±dp	n(%)
Age (years)^*	65 ± 16
Gender (male) †		18(58)
Ethnicity (Caucasian)		21(71)
Years of education^*	6 ± 3
Work status (retired)		18(58)
Living with two or more family members		26(83)
Family income (minimum wages)^*	3 ± 1
Cause of heart failure
Ischemia		12(37.5)
Hypertension		8(25)
Left ventricular ejection fraction ^*	30 ± 7
Number of medications prescribed^*	7 ± 2
Previous hospitalizations		21(67)
Comorbidities
Systemic arterial hypertension		20(62.5)
Diabetes mellitus		12(37.5)
Dyslipidemia		11(33.3)
Functional class I-II in home visit 1		18(58)
Functional class I-II in home visit 3		24(75)

Questions	Visit 1 n(%)	Visit 3 n(%)
1. During the past 15 days, have you taken all your medications correctly, as prescribed by the doctor?	20(62.5)	22(68.8)
2. Do you check your weight everyday?	0	8(25)
3. Do you refrain from putting salt in your food?	31(96.9)	31(96.9)
4. Do you avoid adding spices, sauces and other salt-containing products to your food?	32(100)	32(100)
5. Do you avoid eating meals and consuming food outside your home, in places where salt restriction is not applied?	23(71.9)	24(75)
6. Do you ever consume soup, ice cream, gelatins, jam, juice, milk, tea, coffee, non-alcoholic beverages, etc. without considering the impact of these foods on your liquid intake?	5(15.6)	17(53.1)
7. Did you decrease liquid intake as per your doctor’s or nurse’s instructions?	13(40.6)	23(71.9)
8. Do you consume fruits rich in liquid, such as oranges, melons, watermelons, pineapples, coconut water, etc., without taking into account the amount of liquid consumed?	19(59.4)	27(84.4)
9. Do you abstain from alcohol?	27(84.4)	29(90.6)
10. Have you attended all your scheduled medical appointments and examinations?	26(81.3)	31(96.9)

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
E-mail: actapaulista@unifesp.br

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[1] Corresponding author: Eneida Rejane Rabelo-Silva. São Manoel street, 963, Porto Alegre, RS, Brazil. Zip Code: 90620-110. eneidarabelo@gmail.com