The Effect Of Telephone Follow-up On Medication Compliance And Re-hospitalization In Rural Elderly Patients With Heart Failure

Objective:1.To investigate the status quo and problems of medication compliance and re-hospitalization rates of elderly patients with heart failure in rural areas.2.Intervention on re-hospitalization rates and medication compliance of elderly heart failure patients in rural areas through telephone follow-up.3.To evaluate the influence of telephone follow-up on re-hospitalization rates and medication compliance of elderly heart failure patients in rural areas.Methods:It has selected a total of 160 rural elderly patients with heart failure diseases as research subjects,which is randomly divided into telephone follow-up group and control group,with 80 cases in each group.The control group received a routine discharge care and did not receive any telephone follow-ups,while accepting telephone counseling.In addition to receiving discharge care,the telephone follow-up group will also have telephone follow-up within 1 week after hospital discharge for a total of 14 weeks.According to the Duffy’s Standard Telephone Follow-up Manuscript,the telephone follow-up includes medication supervision,health education,lifestyle guidance,etc..The telephone follow-up time is around 15 minutes,and the frequency of calls will gradually reduced.During the first to fourth weeks after hospital discharge,the telephone follow-up will be once a week.From the 5th to 10th week after hospital discharge,patients will receive the telephone follow-up every 2 weeks,and for the 10th to 14th weeks after hospital discharge,and telephone follow-up will be every 4 weeks.The investigators will collect data at two time points of before hospital discharge and at the end of the 15th week of the telephone follow-up.Jing Meng’s medication adherence questionnaire will be used to evaluate the patient’s medication compliance.And the Memorial Heart Failure Symptom Assessment Scale will be used to evaluate the post-discharge heart failure symptoms control effect of the patients.The Pittsburgh sleep quality index(PSQI)will be used to evaluate the sleep quality of the patients,and the chronic heart failure medication belief questionnaire will be used to evaluate the drug taking faith,and at last,using SPSS 22.0 software to carry out the data analysis.Results:1.After 14 week s of telephone follow-up,the re-hospitalization rate of the telephone follow-up group and the control group within 90 days was 5.0%and 15.0%,while the rate of the telephone follow-up group was significantly lower(P<0.05).2.After 14 weeks of telephone follow-up,the total scores of PSQI of the telephone follow-up group and the control group were respectively 5.18±0.97 and 9.70±2.11,for which the telephone follow-up group was significantly lower than the control group(P<0.001).3.After 14 weeks of telephone follow-up,the evaluation of Memorial heart failure symptoms has showed that the occurrence rate of breath hard,dizziness,anxiety and sensory stress of the telephone follow-up group was significantly lower than that in the control group(P<0.05),while the occurrence rate of other symptoms didn’t have any statistical differences(P>0.05).After 14 weeks telephone follow-up,the symptoms classification of breath hard,dizziness,palpitations,nighttime sleep awakening,difficulty breathing when lying down,difficulty sleeping,nausea and constipation was significantly lower than that of the control group(P<0.05).4.After 14 weeks telephone follow-up,the evaluation score of the medication taking faith of the telephone follow-up group was significantly higher than that of the control group(P<0.05).Conclusions:Telephone follow-up can significantly improve the medication adherence situation of the elderly patients with heart failure in the village,reduce the risk of re-admission,and has a high application value for the hospital disease management of the patients with heart failure in the village.