Feasibility of including patients with migration background in a structured heart failure management programme: A prospective case-control study exemplarily on Turkish migrants.

Christian Alfons Schneider,Marcus Wähner,Elisabeth Kohnen,Hans-Wilhelm Höpp,Birgit Mews,Peter Ihle,Ute Karbach,Hasan Aslan,Roman Pfister

doi:10.1371/journal.pone.0187358

Christian Alfons Schneider, Marcus Wähner + Show 7 more

Open Access

https://doi.org/10.1371/journal.pone.0187358

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Abstract

AimsStructured management programmes deliver optimized care in heart failure patients and improve outcome. We examined the feasibility of including patients with migration background speaking little or no German in a heart failure management programme.Methods and resultsAfter adaption of script material and staff to Turkish language we aimed to recruit 300 Turkish and 300 German (control group) patients within 18 months using the operational basis of a local heart failure management programme for screening, contact and inclusion.Of 488 and 1,055 eligible Turkish and German patients identified through screening, 165 Turkish (34%) and 335 German (32%) patients consented on participation (p = 0.46). General practitioners contributed significantly more of the Turkish (84%) than of the German patients (16%, p<0.001). Contact attempts by programme staff were significantly less successful in Turkish (52%) than in German patients (60%, p = 0.005) due to significantly higher rate of missing phone numbers (36% vs 25%), invalid address data (28% vs 7%) and being unreachable by phone more frequently (39% vs 26%, all p<0.001). Consent rate was significantly higher in successfully contacted Turkish (63%) compared to German patients (50%, p<0.001).ConclusionThe inclusion of Turkish minority patients into a heart failure management programme is feasible with higher consent rate than in Germans. However, effort is high due to inherent logistic adaptions and barriers in identification and contacting of patients.Trial registrationDRKS00007780

Highlights

Heart failure is a major public health problem in Western countries
The high morbidity of heart failure patients substantially affects quality of life [3] and causes enormous health care costs through an excess in hospitalizations [2,4]
Since this might at least partly explain the adverse clinical outcome [13] observed in minority heart failure patients there is a particular need of multidisciplinary management programmes which address many of the above deficiencies in these patients

Summary

Introduction

Heart failure is a major public health problem in Western countries. Approximately 1–2% of the adult population has heart failure and in the context of ageing populations the prevalence is projected to increase by 23% till the year 2030 [1]. There is evidence from the U.S showing that ethnic minority patients have less access to advanced medical care and guideline based diagnostics and treatment, and show less therapy adherence and have less knowledge on their disease [9,10,11,12]. Since this might at least partly explain the adverse clinical outcome [13] observed in minority heart failure patients there is a particular need of multidisciplinary management programmes which address many of the above deficiencies in these patients

Methods

Results

Conclusion