Effects of a multidisciplinary management program on symptom burden and medication adherence in heart failure patients with comorbidities: A randomized controlled trial

BMC Nursing

Research

Tahereh Toulabi¹  Nasrolah Moradifar²  Mehdi Birjandi³  Mohammad Gholami⁴  Shirin Hasanvand⁴  Parvin Ghobadi⁵ 

[1] Cardiovascular Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran;Interventional Cardiology Fellowship, Department of Cardiology, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran;Nutritional Health Research Center, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran;Social Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran;Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran;

关键词: Comorbidities;    Disease management;    Heart failure;    Medication adherence;    Symptom burden;   

DOI  :  10.1186/s12912-022-01130-7

 received in 2022-06-13, accepted in 2022-11-29,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundComorbidities in heart failure (HF) are a complex clinical challenge. There is little data on the benefits of multidisciplinary postdischarge management programs in such patients. This study aimed to examine the effects of a multidisciplinary management program (MMP) on symptom burden and medication adherence in HF patients with comorbidities.MethodsIn this clinical trial study, 94 HF patients with comorbidities were assigned to intervention (n = 47) and control (n = 47) groups by the stratified-random method. The intervention group underwent MMP supervised by a nurse for two months after discharge, including multi-professional visits, telephone follow-ups, and an educational booklet. Medication adherence and symptom burden were assessed using Morisky Medication Adherence Scale (MMAS) and Edmonton Symptom Assessment Scale (ESAS), respectively, on three occasions: Before discharge, six weeks, and eight weeks after discharge.ResultsBoth groups almost matched at the baseline, and the most frequent comorbidities included myocardial infarction (MI), hypertension, peptic ulcer, and depression, respectively. The interactive effect of time in groups showed that mean changes in total scores of symptom burden and medication adherence were significantly different (P < 0.001) at other time points. A significant increase in medication adherence (P < 0.001) and a significant reduction in the burden of all symptoms were observed in the intervention group compared to the control group from Time 1 to Time 3.ConclusionsThe MMP (targeting comorbidity) is a promising strategy for managing symptoms and medication adherence in HF patients with comorbidities.

【 授权许可】

CC BY   
© The Author(s) 2022

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