Factors Associated With Adherence to 14-Day Office Appointments After Heart Failure Discharge

Abstract

BackgroundFollow-up within 14 days after hospital discharge for heart failure (HF) may prevent 30-day hospital readmission, but adherence varies. The purpose of this study was to determine predictors of nonadherence to scheduled appointments. Methods and ResultsA medical record review included patients hospitalized for decompensated HF at 3 health system hospitals who had a scheduled 14-day office appointment. Patient demographics, and social, HF, and hospital factors were studied for association with appointment adherence. Multivariable modeling was used to determine the odds of missing scheduled appointments. Of 701 cases, mean (standard deviation) age was 73.5 (13.8) years, 46.4% were female and 38.9% were nonwhite. Appointment nonadherence was 16.2%. In multivariate analyses, 4 factors predicted missed appointments: drug use history (odds ratio [OR], 3.95; 95% confidence interval [CI], 1.70–9.20; P < .001), nonwhite race (OR, 1.85; 95% CI, 1.08–3.16; P = .024), pulmonary disease (OR, 1.80; 95% CI, 1.12–2.87; P = .014), and anemia (OR, 1.58; 95% CI, 1.01–2.46; P = .044). Scheduling appointments postdischarge vs predischarge was not associated with missed appointments (OR, 0.72; 95% CI, 0.45–1.15; P = .17). ConclusionsFindings may help practitioners identify patients who are likely to miss a follow-up visit; all 4 predictors were easily retrievable from medical records during hospitalization.