Objective
Despite efforts to improve outcomes in heart failure (HF), readmission rates remain
relatively high. Reasons for readmission from different perspectives (patient, caregiver,
health care providers) may help to optimize the future management of patients with
HF. The aims of this study are to 1) gain insight into reasons for HF readmission
from the perspective of patients, caregivers, cardiologists, and HF nurses; 2) examine
similarities and differences in perspectives on the reason for an HF readmission,
and 3) describe possibilities to prevent an HF readmission from different perspectives.
Methods and Results
Data on reasons for readmission were collected on 173 readmissions. Perspectives of
patients, caregivers, cardiologists, and HF nurses were collected by interview and
questionnaire. Worsening HF as the sole reason for readmission was reported most often;
however, 36% of caregivers, 56% of patients, and 63% to 65% of health care providers
indicated that other factors, such as comorbidity, nonadherence, and nonoptimal medication,
were important contributing factors. In only 34% of readmissions, patients and their
caregivers agreed with health care providers on the underlying reason. Respondents
reported that 23% to 31% of the readmissions could probably have been prevented if
adherence were higher, patients requested help earlier, and adequate multidisciplinary
professional help were available.
Conclusion
To prevent future readmissions of patients with HF, it is important to fully understand
the reasons for readmission by gaining insight on the reason for readmission from
different perspectives. Also, we may need another approach to prevent adverse outcomes
in which other medical problems and new strategies to improve adherence have to be
considered.
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Article info
Publication history
Published online: January 22, 2009
Footnotes
This study was supported by The Netherlands Heart Foundation (Grant 2000Z003).
Identification
Copyright
© 2009 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
