Impact of pharmaceutical care on the quality of life of patients with heart failure due to chronic Chagas disease: Randomized clinical trial

Abstract

Chronic Chagas disease (ChD) has high morbimortality and loss in quality of life due to heart failure (HF). Pharmaceutical care (PC) optimizes clinical treatment and can improve quality of life in HF. We evaluated if PC improves quality of life of patients with ChD and HF. Single-blinded, randomized, controlled trial that assigned adult patients with ChD and HF (81 patients; 61 ± 11 years; 48% male) to PC (n = 40) or standard care (n = 41). Quality of life according to SF-36 and Minnesota living with HF questionnaires, incidence of drug-related problems (DRPs), and adherence to medical treatment were determined at baseline and at every 3 months for 1 year. Intention-to-treat analyses were performed by mixed linear model to verify the treatment effect on the changes of these variables throughout the intervention period. Relative changes from baseline to 1 year of follow-up of the domains physical functioning (+16.6 vs -8.5; P<.001), role-physical (+34.0 vs +5.2; P = .01), general health (+19.4 vs -6.1; P<.001), vitality (+11.5 vs. -5.8; P = .003), social functioning (+7.5 vs -13.3; P = .002), and mental health (+9.0 vs -3.7; P = .006) of the SF-36 questionnaire and the Minnesota living with HF questionnaire score (-12.7 vs +4.8; P<.001) were superior in the PC group than in the standard care group. Adherence to medical treatment increased as early as after 3months of follow-up and DRPs incidence decreased after 6months of follow-up only in the PC group. Patients with ChD and HF who received PC presented improved quality of life, decrease in DRP frequency, and increase in medication adherence.