Non-pharmacological management of patients hospitalized with heart failure at a teaching hospital.
OBJECTIVE
To describe non-pharmacological management of patients admitted with heart failure (HF) in a teaching hospital.


METHODS
A cohort longitudinal study of patients diagnosed with HF according to the Boston score. Within the first 72 hours of admission, the nursing staff of the HF clinic conducted structured interviews and medical chart reviews.


RESULTS
Two hundred and eighty-three admissions of 239 patients (age = 64 +/- 15 years) were evaluated; approximately 50% of the patients were male and 37% had heart failure of ischemic etiology Non-pharmacological measures included salt restriction in 97%, urine output monitoring in 85%, fluid balance in 75%, weight monitoring in 61%, and fluid restriction in only 25% of the patients. However, they were often not carried out by the team in charge (p < 0.01 for all comparisons). Irregular use of prescribed drugs in the week prior to admission was 22% and 21% in non-readmitted and readmitted patients, respectively (p = 1.00). Readmitted patients (n = 38) had severe systolic dysfunction, more previous hospitalizations, and longer duration of HF symptoms, as compared to those non-readmitted; in addition they had better knowledge related to self-care (p values < 0.05). In the multivariate analysis, only duration of symptoms remained as an independent predictor of re-admissions.


CONCLUSIONS
Our data suggest that, even at a teaching hospital, important gaps exist between prescribing non-pharmacological measures for HF patients and their being carried out. Readmitted patients seem to have good understanding of their condition; this finding, however, is significantly associated with HF severity and time of onset.
Rabelo
Eneida R
ER
Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Aliti
Graziella B
GB
Goldraich
Lívia
L
Domingues
Fernanda B
FB
Clausell
Nadine
N
Rohde
Luis E
LE
D002303:Cardiac Output, Low / Q000517:prevention & control / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006760:Hospitalization / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011446:Prospective Studies; D012648:Self Care / Q000706:statistics & numerical data; D012720:Severity of Illness Index