Keywords

ambulatory patients, chronic heart failure, dropout, Multidisciplinary Heart Failure Unity, nonadherence

Authors

1. Alvarez Rocha, Pablo MD
2. Ormaechea, Gabriela MD
3. Pouso, Jorge MD
4. Batista, Ignacio MD
5. Estrago, Virginia MD
6. Fernandez, Paola MD
7. Florio, Lucia MD
8. Icasuriaga, Lidia SA
9. Muniz, Patricia MD
10. Ortiz, Virginia MD
11. Parma, Gabriel MD
12. Ricca, Roberto MD
13. Rios, Luz T. MD
14. Silvera, Gabriela MD
15. Kuster, Fernando MD
16. Rocha, Alfredo Alvarez MD
17. Lluberas, Ricardo MD
18. UMIC Group

Abstract

Background: Chronic heart failure is a growing public health issue that is reaching epidemic proportions. In the last few years, multidisciplinary management programs have been developed to improve its management. Yet, some patients take advantage of these programs, whereas others do not.

Methods: Several demographic, medical, and social variables were evaluated as contributors to dropout after enrollment into a multidisciplinary heart failure program using a nested case-control design. A total of 14 patients and 42 controls were interviewed using a standardized questionnaire. Possible associations were explored by means of [chi]² Mantel-Haenszel test and a binary logistic regression model.

Results: The only significant factor associated with dropout was social isolation. Patients who lived alone, without family support, had a significantly greater dropout risk (odds ratio, 12.5; 95% confidence interval, 1.35-11.6).

Conclusions: For patients who live alone, an individualized approach may be better than a multidisciplinary management program, but this hypothesis should be investigated in future studies.