Doenças Cardiovasculares e Diagnóstico

The Impact of a Comprehensive Medication Counseling and Education on Rehospitalization and Mortality of Advanced Heart Failure Patients in Ghana

Abstract

Charles Anane, K Ohene-Buabeng, K Sarpong and IK Owusu

The burden of advanced heart failure includes debilitating symptoms, frequent re-hospitalization and high rates of mortality. The most common causes of this preventable rehospitalization are patient’s failure to adhere to prescribed medicines and diet regimen. It is imperative that any medication counseling and educational program seeks to assess the patients understanding of their medical conditions and ability to appreciate the importance of medication compliance to their condition. A prospective cohort study involving 583 patients aged ≥ 30 years who met clinical criteria for presence of advanced heart failure on admission was done to assess the outcome of the program on mortality and re-hospitalization. 497 patients were discharge to the cardiac clinic for a 6-month follow up during which period they were taken through medication counseling and education on; Medication Compliance, Smoking, Alcohol, Diet and Nutrition, Salt restriction, Fluid intake, Weight loss and Exercise. The study showed 97.6% decrease in re-hospitalization rate and 12.4% decrease in mortality. Patients had also significantly improved in subjective and objective indices to functional status. 93.8% were classified within NYHA function class II and 6.2% in function class III. None of the patients remained in functional class IV as compared to 46.5% of the patients before discharge. The study showed that management of heart failure patients based on well structured medication education and counseling modalities can contribute to improved patients outcomes, including reduced morbidity and mortality rates, improved functional status and quality of life.