Estimation of the prognostic role of patients’ adhesion to treatment and Charlson comorbidity index as predictors of chronic heart failure decompensation


DOI: https://dx.doi.org/10.18565/therapy.2024.9.68-78

Pyrikova N.V., Mozgunov N.A., Osipova I.V., Molchanova A.A.

1) Altai State Medical University of the Ministry of Healthcare of Russia, Barnaul; 2) Regional Clinical Hospital of Emergency Medical Care No. 2, Barnaul
Abstract. Chronic heart failure (CHF) is an important medical, economic and social problem. Studying the problem of CHF comorbidity and patients’ adherence to treatment is important for reducing the risk of CHF decompensation and hospitalization.
The aim: to study the role of adherence of patients to treatment and the role of Charlson comorbidity index as predictors of CHF decompensation.
Material and methods. Medical records of 297 patients admitted with decompensated CHF throughout the year (age 73.3 ± 10.4 years, 58.6% females) were analyzed. All the participants were divided into two groups: patients who had re-hospitalizations (n = 190) and patients without re-hospitalizations for decompensated CHF within 12 months before the index event (n = 107).
Results. Patients with moderate level of comorbidity predominated 1.5 times and patients with significant level of comorbidity predominated 1.3 times among patients with repeated hospitalizations due to decompensated CHF, comparatively to the group without repeated hospitalizations. Charlson comorbidity index of 5 points was associated with re-hospitalization due to decompensated CHF within 12 months (sensitivity 66.32%, specificity 69.16%). In the group of patients with re-hospitalizations, 32.1% of patients complied with recommendations for drug therapy, 17.9% – with non-drug methods and self-control. Adherence to non-drug treatment methods and self-control reduces the chances of re-hospitalization with decompensated CHF within 12 months by 6.6% (95% CI: 0.032–0.133), and adherence to drug treatment by 25.5% (95% CI: 0.136–0.480).
Conclusion. Combination of comorbidity and non-adherence to treatment and self-control increases the risk of hospitalization for decompensated CHF. Further study of factors associated with non-adherence to therapy in patients with CHF is necessary, that will allow to optimize approaches to the management of such kind of the patients.
Keywords: chronic heart failure decompensation, adherence to treatment, comorbidity, hospitalization, chronic heart failure
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About the Autors

Natalya V. Pyrikova, MD, Dr. Sci. (Medicine), associate professor, professor of the Department of faculty therapy and occupational diseases, Altai State Medical University of the Ministry of Healthcare of Russia. Address: 656038, Barnaul, 20 Molodezhnaya St.
E-mail: allinatali@mail.ru
ORCID: https://orcid.org/0000-0003-4387-7737
Nikita A. Mozgunov, MD, head of the Admission Department of Regional Clinical Hospital of Emergency Medical Care No. 2. Address: 656038, Barnaul, 73 build. 2 Komsomolsky Avenue.
E-mail: nikita-mn@mail.ru
ORCID: https://orcid.org/0000-0001-7335-377X
Irina V. Osipova, MD, Dr. Sci. (Medicine), professor, head of the Department of faculty therapy and occupational diseases, Altai State Medical University of the Ministry of Healthcare of Russia. Address: 656038, Barnaul, 20 Molodezhnaya St.
E-mail: i.v.osipova@gmail.com
ORCID: https://orcid.org/0000-0002-6845-6173
Anna A. Molchanova, MD, PhD (Medicine), associate professor of the Department of faculty therapy and occupational diseases, Altai State Medical University of the Ministry of Healthcare of Russia. Address: 656038, Barnaul, 20 Molodezhnaya St.
E-mail: anna2009-84@mail.ru
ORCID: https://orcid.org/0000-0001-5074-8373


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