Patient compliance and physicians’ adherence to guidelines on heart failure with reduced ejection fraction

The Role of Structured Telephone Support in the Development of Self-care in Comorbid Patients with Chronic Heart Failure

Aim. To research the effect of structured telephone support on the self-care in comorbid patients with chronic heart failure (CHF) over 12 months of follow-up.Material and methods. Self-care was assessed using The Self-care of Heart Failure Index (SCHFI, version 6.2) in 130 patients with CHF II-IV functional class according to NYHA, mean age 63.2±9.6 years old, left ventricular ejection fraction averaged 47.1±11.6%, men (70.8%) and patients with ischemic etiology of CHF (78.5%) prevailed. After fixed simple randomization by the envelope method, the patients were divided into groups of standard (control) and active outpatient follow-up (additional telephone contacts or correspondence using available messengers – structured telephone support). All patients received CHF therapy in accordance with the current Russian clinical guidelines. The indicators evaluated initially and after 12 months of follow-up.Results. Over 12 months, total SCHFI scores increased significantly by 62% in the telephone support group and by 34.7% in the comparison group (p<0.001). A significant maximum improvement in the score was noted in section B of this scale (self-care management) in patients in the telephone support group (by 100%; p<0.001).There was an improvement in the clinical condition and an increase in exercise tolerance in both groups, somewhat more in the telephone support group (p>0.05).However, there were no statistically significant differences in the intake of the main groups of drugs and the achievement of their target dosages (p>0.05).Conclusion. The study found a positive effect of structured telephone support on the self-care and the clinical condition of patients with CHF, although it did not reach the maximum possible acceptable values. Further studies are need to assess the self-care in patients with CHF.