A heart failure program in low-income patients in Argentina(COMM-HF)

Rosana Poggio; Lucia Marianela Ortiz; Natalia Rivadulla; María José Martínez; Lucrecia María Burgos; Laura Gutiérrez; Javier Mariani; José P. Lopez-Lopez; Eduardo Chuquiure-Valenzuela; Modou Jobe; Taofeek Awotidebe; Amitava Banerjee; Guillermo Cursack; Abraham Samuel Babu; Vilma Irazola; Juan Martín Brunialti; Mariano Maydana; Diego Federico Echazarreta

doi:10.47487/apcyccv.v5i4.432

Autores/as

Rosana Poggio Department of Research in Chronic Diseases, Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina; Center for Research in Epidemiology and Public Health (CIESP-CONICET), Buenos Aires, Argentina. https://orcid.org/0000-0002-3339-2421
Lucia Marianela Ortiz Hospital de Alta Complejidad en Red «El Cruce», Florencio Varela, Buenos Aires, Argentina; Hospital San Juan de Dios, Provincia de Buenos Aires, Buenos Aires, Argentina. https://orcid.org/0009-0003-2799-9395
Natalia Rivadulla Hospital San Juan de Dios, Provincia de Buenos Aires, Buenos Aires, Argentina.
María José Martínez Hospital San Juan de Dios, Provincia de Buenos Aires, Buenos Aires, Argentina.
Lucrecia María Burgos Instituto Cardiovascular Buenos Aires (ICBA), Buenos Aires, Argentina. https://orcid.org/0000-0002-3999-1265
Laura Gutiérrez Department of Research in Chronic Diseases, Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina. https://orcid.org/0000-0002-9423-4320
Javier Mariani Hospital de Alta Complejidad en Red «El Cruce», Florencio Varela, Buenos Aires, Argentina. https://orcid.org/0000-0002-9372-6817
José P. Lopez-Lopez Instituto de Investigaciones Masira, Universidad de Santander, Santander, Colombia. https://orcid.org/0000-0001-8865-0929
Eduardo Chuquiure-Valenzuela Clinical Hospitalization Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico city, Mexico. https://orcid.org/0000-0003-4812-1090
Modou Jobe The Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Atlantic Boulevard, Fajara, The Gambia. https://orcid.org/0000-0001-5309-5611
Taofeek Awotidebe Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile - Ife, Nigeria. https://orcid.org/0000-0002-8583-9467
Amitava Banerjee Institute of Health Informatics, University College London, UK. https://orcid.org/0000-0001-9241-3555
Guillermo Cursack Sanatorio Esperanza, Santa Fe, Argentina. https://orcid.org/0000-0002-6382-1987
Abraham Samuel Babu Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India. https://orcid.org/0000-0003-1084-0137
Vilma Irazola Department of Research in Chronic Diseases, Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina; Center for Research in Epidemiology and Public Health (CIESP-CONICET), Buenos Aires, Argentina. https://orcid.org/0000-0002-6100-1862
Juan Martín Brunialti Hospital San Juan de Dios, Provincia de Buenos Aires, Argentina. https://orcid.org/0009-0004-2989-8528
Mariano Maydana Hospital de Alta Complejidad en Red «El Cruce», Florencio Varela, Buenos Aires, Argentina; Hospital San Juan de Dios, Provincia de Buenos Aires, Argentina. https://orcid.org/0000-0002-0600-4905
Diego Federico Echazarreta Hospital San Juan de Dios, Provincia de Buenos Aires, Argentina. https://orcid.org/0000-0002-3859-7899

DOI:

https://doi.org/10.47487/apcyccv.v5i4.432

Palabras clave:

Heart Failure, Community Health Workers, Implementation Science, Ambulatory Care, Treatment Adherence and Compliance, Argentina

Resumen

Objective. In low- and middle-income countries, heart failure (HF) is the leading cause of death and disability. Materials and methods. A feasibility study was conducted to assess the fidelity, reach, and adoption of an educational program led by non-medical staff to improve outpatient care for patients hospitalized with HF in the local public health system. Results. Thirty patients were included, with a mean age of 55.3 years (63.3% male). A total of 97.3% of planned home visits and 90% of scheduled phone calls were completed. Counselling modules were delivered during 90.4% of home visits, with no significant challenges reported during implementation. At the end of follow-up, there was a trend towards improved lifestyle habits, a reduction in mean heart rate (78.0 to 68.3 beats per minute; p = 0.016), a decrease in the proportion of patients in NYHA functional class III (20% to 7.4%; p = 0.041), and a slight reduction in mean body mass index (29.5 vs. 28.9; p = 0.042). Conclusions. A home-based educational program, designed to optimize outpatient management of heart failure and led by non-medical healthcare personnel, was well-received and demonstrated feasibility for implementation in low-income patients relying solely on the Argentine public health system.

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