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. 2024 Dec 11;5(4):215-225.
doi: 10.47487/apcyccv.v5i4.432. eCollection 2024 Oct-Dec.

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

Rosana Poggio  1   2 , Lucia Marianela Ortiz  3   4 , Natalia Rivadulla  4 , María José Martínez  4 , Lucrecia María Burgos  5 , Laura Gutiérrez  1 , Javier Mariani  3 , José P Lopez-Lopez  6 , Eduardo Chuquiure-Valenzuela  7 , Modou Jobe  8 , Taofeek Awotidebe  9 , Amitava Banerjee  10 , Guillermo Cursack  11 , Abraham Samuel Babu  12 , Vilma Irazola  1   2 , Juan Martín Brunialti  4 , Mariano Maydana  3   4 , Diego Federico Echazarreta  4
Affiliations

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

Rosana Poggio et al. Arch Peru Cardiol Cir Cardiovasc. .

Abstract
in English, Spanish

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.

Objetivo: En los países de ingresos bajos y medianos la insuficiencia cardíaca (IC) es la principal causa de muerte y discapacidad.

Materiales y métodos: Se desarrolló un estudio de factibilidad para evaluar la fidelidad, alcance y adopción de un programa educativo liderado por personal no médico para mejorar la atención ambulatoria en pacientes hospitalizados por IC en el sistema de salud público local.

Resultados: Se incluyeron treinta pacientes con una edad media de 55,3 años, (varones: 63,3%). Se realizaron el 97,3% de las visitas domiciliarias y el 90% de las llamadas telefónicas planificadas. Se implementaron los módulos de consejería en el 90,4% de las visitas en el hogar y no se reportaron dificultades relevantes durante la implementación de estos. Al final del seguimiento se observó una tendencia a la mejoría de los estilos de vida, reducción en la frecuencia cardíaca media (78,0 a 68,3 latidos por minuto; p = 0,016), reducción en la proporción de pacientes en clase funcional III de la NYHA (20% a 7,4%; p = 0,041) y una ligera reducción en la media del índice de masa corporal (29,5 vs. 28,9; p = 0,042).

Conclusiones: Un programa educativo domiciliario, diseñado para optimizar el manejo ambulatorio de la insuficiencia cardíaca y liderado por personal de salud no médico, tuvo buena aceptación y demostró ser factible de implementar en pacientes de bajos ingresos que cuentan exclusivamente con la cobertura del sistema de salud público argentino.

Keywords: Ambulatory Care; Argentina; Community Health Workers; Heart Failure; Implementation Science; Treatment Adherence and Compliance.

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Conflict of interest statement

Conflicts of interest: The authors declare no conflict of interest.

Figures

Figure 1
Figure 1. Flow diagram of study participants.
See this image and copyright information in PMC

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