Efecto del seguimiento telefónico en la adherencia al tratamiento en los pacientes con falla cardiaca

Objective: This work sought to determine the effect of telephone monitoring on levels of adherence to pharmacological and non-pharmacological treatment in patients attending a heart failure program in a tier IV health care institution. Method: Controlled clinical trial (n = 61) in which patients were randomized to telephone monitoring or to usual monitoring. To determine the effect of the intervention, three measurements were made of the adherence levels: prior to monitoring, at 12 months, and 6 months after finishing the monitoring. The Cochran-Armitage trend test was used, along with a multivariate analysis with a quantile mixed logistic model. Results: Patients with telephone monitoring tended to classify in levels of greater adherence than those from the control group (p < 0.0001). The multivariate model shows an association between the adherence scores and the telephone monitoring, which depend on time, percentiles studied, and the distribution. There was greater adherence with the intervention of the second visit in the distribution's low quantiles (P10 and P25) and, in the third, in the highest quantiles (P50, P75, and P90). Variables, like male gender (P10 and P25), university schooling (P10 and P90), and presence of a caregiver (P90) were associated with higher adherence levels. Conclusions: Telephone monitoring becomes an effective intervention that promotes motivation, self-management, and assertive communication with patients, whenever it is carried out in standardized manner.