Summary
Impact of self-management of therapy on use of emergency health care services by patients with chronic diseases: a cohort study
Affiliation of the authors
DOI
Quote
Torres Pérez LF, Morales Asencio JM, Jiménez Garrido M, Copé Luengo G, Sánchez Gavira S, Gómez Rodríguez JM. Impact of self-management of therapy on use of emergency health care services by patients with chronic diseases: a cohort study. Emergencias. 2013;25:353-60
Summary
Objective: To determine whether ineffective management of therapeutic regimen is a
predictor of frequent use of health care resources and poor quality of life in patients with
chronic illnesses.
Methods: Prospective cohort study. Two cohorts were formed in 2007 on the basis of
presence or absence of ineffective management. The patients were evaluated for 12
months to assess quality of life, adherence to therapy, and use of health care resources.
Results: Of 302 patients included, 167 (55.29%) were in the ineffective-management
cohort. In addition to poor adherence to therapy, such patients tended to be men,
hypertensive, and on several medications. The risk of readmission in this cohort was
nearly 4-fold higher during the 12-month period (odds ratio, 3.72; 95% CI, 2.19-6.32;
P<.0001) according to a 10-item scale (DecaMIRT). The patients with low adherence to therapy had quality of life scores that were significantly lower by a mean of more than 5 points (95% CI, 2.60-7.258; P<.05). Conclusions: In patients with chronic diseases, effective management of therapeutic regimen is associated with quality of life and a different pattern of use of health care resources. The DecaMIRT scale proved valid for measuring adherence to therapy and can help improve how persons with chronic diseases are attended in the emergency department.
