CONGRESS ABSTRACT

Background: Heart failure (HF) is a clinical syndrome with a great social burden, causing several hospitalizations which are often correlated with an inadequate adherence to therapy. The aim of this study is to evaluate if an educational and supporting program guided by a nursing team, could produce an improvement in adherence to treatment and if this correlates with better clinical outcomes. Materials and Methods: 91 HF patients referred at the dedicated follow-up pathway were evaluated, according to a prospective observational protocol. All patients  have been included in an educational and support program guided ed by the nursing team (Table 1A). Patients were administered a questionnaire regarding adherence to drug treatment. The questionnaire (MMAS-8 score) included 8 questions (Table 1B); adequate adherence was identified with a score >8 points, moderate adherence with a score >6 and <8 points, and poor adherence with a score <6 points. All patients were re-evaluated after 4 months, both clinically and again with the adherence questionnaire, evaluating the possible benefit in the observation period. Results: A significant increase in the adherence score was observed in follow-up (Fup)  6.2 (±2.9) vs 7 (±2.1) points, p 0.02 (Fig 1). At baseline, 39% of patients were high adhered, 35% moderate adherence, 26% poor adherence. During the observation period, 43 clinical outcomes were observed, 22 hospitalizations for HF, 10 therapeutic remodeling interventions, 10 admissions to emergency department for dyspnea or HF related symptoms, 1 death. Patients are divided according to the change in adherence score, and the clinical outcomes in the various groups are quantified. Most events occur in patients with poor baseline adherence who do not change in Fup (n 17, Group D) and in patients without adherence improvement (n 12, Group C). In patients group with high adherence to Fup, regardless of baseline adherence (n 8, Group B) few total events were observed and no significant difference in events is observed when compared with already basic adherent patients (n 6, Group A) p n.s. (Fig 2). Conclusions: The data of our study have confirmed how an educational and support path managed by a nursing team produces an increase in therapeutic adherence. The increase in adherence is correlated with a trend towards fewer clinical events in the observation period.