title: Reasons for readmission in heart failure: Perspectives of patients, caregivers, cardiologists, and heart failure nurses.
abstract: OBJECTIVE
  Despite efforts to improve outcomes in heart failure (HF), readmission rates remain relatively high. Reasons for readmission from different perspectives (patient, caregiver, health care providers) may help to optimize the future management of patients with HF. The aims of this study are to 1) gain insight into reasons for HF readmission from the perspective of patients, caregivers, cardiologists, and HF nurses; 2) examine similarities and differences in perspectives on the reason for an HF readmission, and 3) describe possibilities to prevent an HF readmission from different perspectives.
  
  
  RESULTS
  Data on reasons for readmission were collected on 173 readmissions. Perspectives of patients, caregivers, cardiologists, and HF nurses were collected by interview and questionnaire. Worsening HF as the sole reason for readmission was reported most often; however, 36% of caregivers, 56% of patients, and 63% to 65% of health care providers indicated that other factors, such as comorbidity, nonadherence, and nonoptimal medication, were important contributing factors. In only 34% of readmissions, patients and their caregivers agreed with health care providers on the underlying reason. Respondents reported that 23% to 31% of the readmissions could probably have been prevented if adherence were higher, patients requested help earlier, and adequate multidisciplinary professional help were available.
  
  
  CONCLUSIONS
  To prevent future readmissions of patients with HF, it is important to fully understand the reasons for readmission by gaining insight on the reason for readmission from different perspectives. Also, we may need another approach to prevent adverse outcomes in which other medical problems and new strategies to improve adherence have to be considered.
authors.affiliation: Department of Cardiology, University Medical Center Groningen, The Netherlands.
authors.forename: Coby
authors.initials: C
authors.lastname: Annema
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Luttik
authors.forename: Tiny
authors.initials: T
authors.lastname: Jaarsma
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D002309:Cardiology / Q000706:statistics & numerical data*; D017028:Caregivers; D037001:Directive Counseling; D018450:Disease Progression; D005260:Female; D019538:Health Care Surveys; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000150:complications* / Q000451:nursing; D006801:Humans; D008297:Male; D009426:Netherlands; D010359:Patient Readmission / Q000706:statistics & numerical data*; D036301:Qualitative Research; D012307:Risk Factors; D012938:Social Perception; D013041:Specialties, Nursing / Q000706:statistics & numerical data*; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires