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Discharge guidance and telephone follow-up in the therapeutic adherence of heart failure: randomized clinical trial* * Paper extracted from master’s thesis “Reinternação e adesão ao tratamento de pacientes com insuficiência cardíaca após orientação de alta e contato telefônico de enfermagem”, presented to Universidade Federal de São Paulo, Escola de Enfermagem, São Paulo, SP, Brazil.

Objective

to evaluate the effectiveness of the behavioral intervention of discharge guidance and telephone follow-up in the therapeutic adherence, re-hospitalization and mortality of patients with heart failure.

Method

randomized clinical trial without blinding, including 201 patients diagnosed with heart failure admitted to the emergency room, who were randomized in Control Group and Intervention Group. Intervention was carried out with specific discharge guidance in the Intervention Group, who were contacted for solving doubts via phone calls after 7 and 30 days, and the adherence to treatment was evaluated after 90 days with the Morisky test, the Brief Medical Questionnaire and the non-drug adherence test in both groups. The Generalized Estimating Equations Model was used (p<0.05%).

Results

One-hundred and one patients were randomly sorted in the Control Group and in the Intervention Group, their average age being 62.6±15.2. The Intervention Group had higher drug and non-drug therapeutic adherence compared to the Control Group (p<0.001) and there were lower re-hospitalization and death rates in the Intervention Group after 90 days.

Conclusion

discharge guidance with telephone follow-up was effective and resulted in greater therapeutic adherence, as well as in decrease of re-hospitalization and death rates in patients with heart failure. Clinical Trial Registration (REBEC): RBR- 37n859

Heart Failure; Education; Clinical Trial; Nursing; Emergency Nursing; Patient’s Discharge


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