Heart failure kills about 10% of patients in Brazil, says unprecedented study

An unprecedented study carried out in Brazil investigated the outcome of patients with heart failure one year after the first hospitalization caused by the complication. Adherence to treatment, mortality and readmission of patients were some of the information compiled with the study.

Called Breathe (Brazilian Registry of Heart Failure), the results of the study were presented at the annual congress of the European Society of Cardiology (ESC), held last week in Barcelona.

“The research is important because it gives us direction on what problem is happening and what is the best way to improve patient care,” said Denilson Albuquerque, a member of the board of directors of the SBC (Brazilian Society of Cardiology).

Heart failure is a failure in the heart’s ability to pump blood. In Brazil, on average 10% of patients die from the disease. Treatment consists mainly of medication, pacemakers and, in critical cases, heart transplantation.

Albuquerque was the one who presented the Breathe results at the ESC congress. According to him, the study has not yet been published in scientific article format, but that should happen soon.

The survey used data from patients with heart failure from all over Brazil. It was divided into two phases: one that took place in 2011 and another in 2016. In total, there were about 3,000 patients who made up the research.

All of them had been hospitalized and were followed up for one year in order to observe their outcomes. One of the points observed was whether the use of medication to treat the heart problem was continued.

“Over time, patients decrease the medication in use,” said Albuquerque, who is also a professor of cardiology at Uerj (University of the State of Rio de Janeiro).

He says that, about a year after admission, half of the patients fail to adopt all the necessary drugs for treatment. “That was the first problem we encountered: poor adherence to medication.”

Readmissions were another point that entered the research analysis. In the first phase of the survey, about 20% of patients needed to be readmitted in just three months. After six months of the first consultation, this rate jumped to 31%.

Solution

The lack of adherence to medication is one of the main factors that lead to critical conditions of heart failure. Albuquerque explains that inconsistent use can cause readmissions, increasing the chances of early death of the patient. In addition, the suspension of treatment influences the emergence of more critical cases that require heart transplantation.

In some cases, there is a lack of availability of medicines in the public health network and, therefore, the patient cannot maintain the treatment. However, discontinuity can also happen due to the person’s lack of sense of risk.

For Albuquerque, one way to overcome this bottleneck is through more effective communication between doctors and patients. He says that it is important to warn about the need to maintain constant medication intake. According to the professor, in some cases the patient needs to ingest several medications, which makes the habit difficult.

Similarly, other healthcare professionals who are not cardiologists need to understand the importance of maintaining treatment in order to communicate this to people.

It was this perception of improving communication that influenced the development of education actions by SBC after the collection of data from the first phase of Breathe. Albuquerque says that lectures were given in Brazil to alert doctors and other health professionals to the need to improve communication with their patients.

The cardiology professor believes that the benefit of these actions can already be seen in the numbers of the second phase of Breathe. This is because parameters such as deaths, days of hospitalization and need for readmission have dropped in relation to those seen in the first part of the survey.