Ò Miró1, R Escoda2, F J Martín-Sánchez3, P Herrero4, J Jacob5, M Rizzi6, A Aguirre7, J A Andueza8, H Bueno9, P Llorens10. 1. Área de Urgencias, Hospital Clínic, Barcelona; Grupo de Investigación «Urgencias: Procesos y Patologías», IDIBAPS, Barcelona, España. Electronic address: omiro@clinic.cat. 2. Área de Urgencias, Hospital Clínic, Barcelona; Grupo de Investigación «Urgencias: Procesos y Patologías», IDIBAPS, Barcelona, España. 3. Servicio de Urgencias, Hospital Clínico San Carlos. Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España. 4. Servicio de Urgencias, Hospital Universitario Central de Asturias, Oviedo, España. 5. Servicio de Urgencias, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España. 6. Servicio de Urgencias, Hospital de la Santa Creu i Sant Pau, Barcelona, España. 7. Servicio de Urgencias, Hospital del Mar, Barcelona, España. 8. Servicio de Urgencias, Hospital Gregorio Marañón, Madrid, España. 9. Servicio de Urgencias, Hospital Gregorio Marañón, Madrid, España; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, España; Instituto de Investigación i+12 y Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, España; Universidad Complutense de Madrid, Madrid, España. 10. Servicio de Urgencias, Corta Estancia y Hospitalización a Domicilio, Hospital General de Alicante, Alicante, España.
Abstract
OBJECTIVE: To understand the perceptions of patients with heart failure (HF) concerning their disease, treatment and support, as well as the specialists who provide care after a decompensation, and to determine whether there is a relationship between the type of specialist involved in the follow-up and the medium-term prognosis. METHODS: A multicentre, prospective cohort study consecutively included patients with acute HF in the emergency department. The patients were interviewed by telephone 91-180days after their emergency department visit. We investigated the relationship between the type of specialist who performed the follow-up and the emergency department visits or hospitalisations using Cox regression models, with progressive adjustment by groups of potential confounders of these relationships. RESULTS: We interviewed 785 patients. Thirty-three percent (95%CI: 30%-36%) considered their disease mild, 64% (60%-67%) required help from third parties for daily activities, 65% (61%-68%) had no recent therapeutic changes, and 69% (67%-72%) received the same treatment in the exacerbations. The perceived support varied significantly depending on the factor under consideration (from greater to lesser: family, hospital, emergency department, health centre, religion and patient associations; p<.05 in all comparisons). Thirty-nine percent (36%-43%) of the patients with decompensations consulted directly with the emergency department, with no prior changes in treatment. At discharge, general practitioners (74%, 71%-77%) and cardiologists (74%, 70%-77%) were the most involved in the follow-up, although the specialty was not related to the prognosis. CONCLUSION: There are various aspects of the perception of patients with HF concerning their disease that are susceptible to future interventions. Patient follow-up involves various specialties, but all achieve similar results in the medium term.
OBJECTIVE: To understand the perceptions of patients with heart failure (HF) concerning their disease, treatment and support, as well as the specialists who provide care after a decompensation, and to determine whether there is a relationship between the type of specialist involved in the follow-up and the medium-term prognosis. METHODS: A multicentre, prospective cohort study consecutively included patients with acute HF in the emergency department. The patients were interviewed by telephone 91-180days after their emergency department visit. We investigated the relationship between the type of specialist who performed the follow-up and the emergency department visits or hospitalisations using Cox regression models, with progressive adjustment by groups of potential confounders of these relationships. RESULTS: We interviewed 785 patients. Thirty-three percent (95%CI: 30%-36%) considered their disease mild, 64% (60%-67%) required help from third parties for daily activities, 65% (61%-68%) had no recent therapeutic changes, and 69% (67%-72%) received the same treatment in the exacerbations. The perceived support varied significantly depending on the factor under consideration (from greater to lesser: family, hospital, emergency department, health centre, religion and patient associations; p<.05 in all comparisons). Thirty-nine percent (36%-43%) of the patients with decompensations consulted directly with the emergency department, with no prior changes in treatment. At discharge, general practitioners (74%, 71%-77%) and cardiologists (74%, 70%-77%) were the most involved in the follow-up, although the specialty was not related to the prognosis. CONCLUSION: There are various aspects of the perception of patients with HF concerning their disease that are susceptible to future interventions. Patient follow-up involves various specialties, but all achieve similar results in the medium term.
Authors: Rosa Antonio-Oriola; Ercole Vellone; Angela Durante; Maddalena De Maria; Marco Di Nitto; Vicente Gea-Caballero; Iván Santolalla-Arnedo; Michał Czapla; José Vicente Benavent-Cervera; Juan Luis Sánchez-González; Raúl Juárez-Vela Journal: J Pers Med Date: 2022-04-12