Introduction: Cardiovascular diseases represent the leading cause of mortality worldwide. Despite the con-stant progress of diagnostic techniques and treatment solutions, congestive heart failure remains a public health challenge and low adherence to treatment re-presents one of the main causes. Objective: To evalu-ate the relationship between the remote assistance and an increase of adherence to treatment in patients with congestive heart failure.
Methods: We conducted a prospective, open rando-mized study consecutively including patients hospita-lized in the Cardiology Department of Cardiovascular Diseases Institute Iasi. We divided the patients in two groups, in order of inclusion, odd numbered patients being part of the intervention group and even numbe-red patients being part of the control group. All pati-ents had received a brochure with detailed information about their condition and were instructed on the im-plementation of pharmacological and dietary regime. The intervention group was assisted through this process by calling them on a daily basis in the first week and weekly afterwards, for one month in total. For eva-luation, we used Morisky Medication Adherence Scale (MMAS – 8), applied at the beginning of the study and after 4 weeks. We performed the statistical analysis of the data using the independent and the paired t-test on the SPSS program v20.
Results: We included in the study 35 patients diagno-sed with NYHA I to III functional class heart failure, 18 in the control group and 17, of which 2 died during the study, in the intervention group. The average du-ration of the calls was 2:50 minutes. We compared the values obtained at the end of the study between the two groups, but also the values obtained at the beginning and the end of the study within each group. As a re-sult of our intervention, the intervention group became more adherent to treatment compared to itself at the beginning of the study (MMAS score 7.73 versus 5.4; p<0.001, 95% confidence interval=-3.43 nd compared to the control group (MMAS score 7.73 ver-sus 6.61, p=0.002, 95% confidence interval=0.46–1.48). NYHA III functional class heart failure patients were more adherent compared to NYHA class I and II pa-tients (MMAS score 7.64 versus 6.25 and 6.86 respec-tively). There was no statistically significant difference regarding the medical adherence related to the number of drugs taken daily, education, age or sex among the groups studied.
Conclusions: Remote assistance might be a solution for increasing the adherence to treatment and con-sequently, the medical outcome in patients with con-gestive heart failure. Considering the premises that adherence to treatment influences the quality of life, morbi-mortality and expenses of rehospitalization and treatment, it is possible that remote assistance could bring sufficient benefits to justify its cost. Further stu-dies, on larger groups, need to be conducted in order to validate this method.