The attitude towards disease management programs in Austrian heart failure patients: a pilot study comparing rural and urban patients

BACKGROUND: Disease Management Programs (DMPs) for heart failure (HF) patients have been developed to better control patients' well-being as well as their daily drug intake. DMPs for HF are not always accepted by the patients, and the reasons for this phenomenon are largely unknown. We hypothesized that patients from rural areas accept a DMP more likely than patients living in a big city. Thus, a pilot study investigated differences in the attitude towards DMPs between HF-patients in one rural and one urban hospital in Austria. METHODS: Patients admitted because of HF to 2 hospitals, one with rural and one with urban populations, were included prospectively by using a questionnaire. RESULTS: Included were 60 patients, 43% females with a mean age of 76 years, in each hospital 30 patients. Rural patients were more interested in a nurse-based DMP than urban (N.=30) (P=0.029). After discharge, urban patients planned more often to attend a specialist than rural (P=0.005). No differences were found regarding gender, age, willingness to be included into a telenursing-based program and estimation of knowledge about HF. CONCLUSIONS: Structures of the health care system and patients' attitudes must be considered when planning DMPs. Development of DMPs which are accepted by urban patients will be relevant for the future.