212 - The Impact of Post Discharge Telephone Follow-up in an Advanced Heart Failure Program in the Middle-East Gulf Region

Abstract

Background: Heart failure and other multiple comorbidities are prevalent in the Middle-East Gulf region. Strict adherence to evidence based therapy and recommendations upon discharge is key in reducing HF readmissions. The 2013 ACC/AHA guidelines recommend a telephone follow-up within 3 days of hospital discharge. Methods: This was an initiative carried out by the HF pharmacist and nurse coordinator of an advanced HF and transplant program at a tertiary center in the Gulf region. Patients who were triaged to the inpatient HF service during admission received a phone call during a twice weekly scheduled phone call sessions. The HF nurse coordinator attempted to confirm preferred phone number during the interview and education session on the day of discharge. During the phone call, specific questions were asked on whether patients had the prescribed discharge medications, and are using them correctly, as well as about their adherence to fluid, salt, exercise instructions and awareness of their next follow-up. All errors were corrected and documented. Patients who could not be reached were contacted a second time the following session. Results: A total of 50 HF patients received a telephone follow-up call between December 1, 2016 and March 1, 2017 and 34 patients (68%) were successfully reached. Patients were reached on average 3.7 ± 1.3 days post discharge and most patients (72%) were with HFrEF. Most patients were following weight, salt, fluid, exercise and medications recommendations but many (30%) were not aware of the follow-up appointment. None were instructed to seek immediate medical attention. A total of 4 patients (8%) were readmitted within 30 days post discharge. Conclusions: Our results show that our inpatient HF service has been effective in reinforcing lifestyle and medication adherence for HF patients as demonstrated in the number of patients correctly following instructions upon discharge and a low 30-day readmission rate. Even though phone numbers were confirmed for most patients prior to discharge many patients could not be successfully reached. The lack of awareness of follow-up appointment is consistent with a higher overall no show rate to appointments in the region compared to western countries.View Large Image Figure ViewerDownload Hi-res image Download (PPT)