Publication: Efecto del seguimiento telefónico en la adherencia al tratamiento en
los pacientes con falla cardiaca
Authors
Achury Saldaña, Diana Marcela ; Fernanda Aponte, Luisa ; Gómez Rodríguez, Johana ; Roa Buitrago, Nubia
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Publisher
Universidad de Murcia
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DOI
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info:eu-repo/semantics/article
Description
Abstract
Objetivo: Determinar el efecto del seguimiento telefónico en los niveles de adherencia al tratamiento
farmacológico y no farmacológico en los pacientes que asisten a un programa de falla cardiaca de una
institución de cuarto nivel de atención.
Método: Ensayo clínico controlado (n = 61) en el que los pacientes se aleatorizaron a seguimiento
telefónico o a seguimiento usual. Para determinar el efecto de la intervención se realizaron tres
mediciones de los niveles de adherencia: antes del seguimiento, a los 12 meses y 6 meses después de
finalizar el seguimiento. Se utilizaron la prueba de tendencia de Cochrane-Armitage y un análisis
multivariado con un modelo logístico mixto de cuantiles.
Resultados: Los pacientes con seguimiento telefónico tuvieron tendencia a clasificarse en niveles de
mayor adherencia que los del grupo control (p < 0.0001). En el modelo multivariado se encuentra una
asociación entre los puntajes de adherencia y el seguimiento telefónico, que dependen del tiempo, en
los percentiles estudiados en la distribución. Hubo mayor adherencia con la intervención de la segunda
visita en los cuantiles bajos de la distribución (P10 y P25) y, en la tercera, en los cuantiles más altos
(P50, P75 y P90). Variables como sexo masculino (P10 y P25), universitarios (P10 y P90) y presencia
de cuidador (P90) estuvieron asociadas con mayores niveles de adherencia.
Conclusiones: El seguimiento telefónico se convierte en una intervención efectiva que promueve la
motivación, la autogestión y la comunicación asertiva con el paciente, siempre y cuando se realice de
manera estandarizada y a lo largo del tiempo.
ABSTRACT: 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.
ABSTRACT: 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.
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Citation
Enfermería Global, Vol. 17, Núm. 3 (2018)
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