Quality care in the management of heart failure in a health area

Objective To analyse the heart failure situation in a health area, as well quality criteria. Method Cross-sectional observational study of patients diagnosed with heart failure by collecting data from their clinical history in the “Turriano” computer program. The variables analysed were, comorbidities, control of cardiovascular risk factors, treatments, number of chronic diseases, and admissions. The level of adherence to drugs in relation to heart failure by determining the ratio between the percentage of prescribed drugs and drugs withdrawn from pharmacy is also analysed using the Turriano prescription program. The study consisted of an improvement cycle or evaluative cycle, following the methodology proposed by Palmer to evaluate the quality of ambulatory care. Results A total of 161 patients were included, with a mean age of 81.24 years, and 54.6% were women. Almost all of them (95%) had disease associated high blood pressure, including diabetes 42.2%, dyslipidaemia 8.9%, obesity 49.1%, and cancer 13.7% Some type of heart disease was diagnosed in 62.2% of patients with 29.2% ischaemic heart disease, 46.6% cardiac arrhythmias, and 20.5% valve diseases. More than 60% had between 4 and 6 concomitant diseases. An acceptable control is observed as regards the cardiovascular risk factors. Diuretic treatment was taken by 70%, with 32% and 35% taking angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists. More than 20% have had 1–2 admissions in the last year, with cardiac decompensation being the main cause. There was 16% mortality. Conclusions Patients with heart failure have a significant number of chronic concomitant diseases, although there is an acceptable cardiovascular risk factors control. There are quality criteria that can be improved.