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. 2017 Nov 8;12(11):e0187358.
doi: 10.1371/journal.pone.0187358. eCollection 2017.

Feasibility of including patients with migration background in a structured heart failure management programme: A prospective case-control study exemplarily on Turkish migrants

Roman Pfister  1   2 , Peter Ihle  3 , Birgit Mews  2 , Elisabeth Kohnen  2 , Marcus Wähner  2 , Ute Karbach  4 , Hasan Aslan  5 , Hans-Wilhelm Höpp  2 , Christian Alfons Schneider  2   6
Affiliations

Feasibility of including patients with migration background in a structured heart failure management programme: A prospective case-control study exemplarily on Turkish migrants

Roman Pfister et al. PLoS One. .

Abstract

Aims: Structured management programmes deliver optimized care in heart failure patients and improve outcome. We examined the feasibility of including patients with migration background speaking little or no German in a heart failure management programme.

Methods and results: After adaption of script material and staff to Turkish language we aimed to recruit 300 Turkish and 300 German (control group) patients within 18 months using the operational basis of a local heart failure management programme for screening, contact and inclusion. Of 488 and 1,055 eligible Turkish and German patients identified through screening, 165 Turkish (34%) and 335 German (32%) patients consented on participation (p = 0.46). General practitioners contributed significantly more of the Turkish (84%) than of the German patients (16%, p<0.001). Contact attempts by programme staff were significantly less successful in Turkish (52%) than in German patients (60%, p = 0.005) due to significantly higher rate of missing phone numbers (36% vs 25%), invalid address data (28% vs 7%) and being unreachable by phone more frequently (39% vs 26%, all p<0.001). Consent rate was significantly higher in successfully contacted Turkish (63%) compared to German patients (50%, p<0.001).

Conclusion: The inclusion of Turkish minority patients into a heart failure management programme is feasible with higher consent rate than in Germans. However, effort is high due to inherent logistic adaptions and barriers in identification and contacting of patients.

Trial registration: DRKS00007780.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Pathways for screening and contacting patients for participation in the heart failure management programme.
HNC indicates staff of the programme.
Fig 2
Fig 2. Cumulative frequency of German and Turkish consented participants over the recruitment period.
Arrows and numbers indicate initiation of actions taken to increase recruitment of Turkish patients (1 and 2: programme promotion in Turkish culture and health care institutions, 3: opening to other health care insurances).
Fig 3
Fig 3
Frequency of German (A) and Turkish (B) eligible and consented patients by recruiting institutions.
See this image and copyright information in PMC

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Grants and funding

This work was supported by the European Union and the Department of Health, Emancipation, Nursing and Ageing of the County Nordrhein-Westfalen [Nr: 005-GW02-037A-C] to HWH. The funder played no role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. The researchers were independent from the funders.
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