Journal of Cardiovascular Nursing Vol. 24, No. 6, pp 475Y481 x Copyright B 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Predictors of Dropout From a Multidisciplinary Heart Failure Program A Nested Case Study Pablo Alvarez Rocha, MD; Gabriela Ormaechea, MD; Jorge Pouso, MD; Ignacio Batista, MD; Virginia Estrago, MD; Paola Ferna ´ ndez, MD; Lucia Florio, MD; Lidia Icasuriaga, SA; Patricia Mun ˜ iz, MD; Virginia Ortiz, MD; Gabriel Parma, MD; Roberto Ricca, MD; Luz T. Rios; Gabriela Silvera, MD; Fernando Kuster, MD; Alfredo Alvarez Rocha, MD; Ricardo Lluberas, MD; UMIC Group Background: Chronic heart failure is a growing public health issue that is reaching epidemic proportions. In the last few years, multidisciplinary management programs have been developed to improve its management. Yet, some patients take advantage of these programs, whereas others do not. Methods: Several demographic, medical, and social variables were evaluated as contributors to dropout after enrollment into a multidisciplinary heart failure program using a nested case-control design. A total of 14 patients and 42 controls were interviewed using a standardized questionnaire. Possible associations were explored by means of # 2 Mantel-Haenszel test and a binary logistic regression model. Results: The only significant factor associated with dropout was social isolation. Patients who lived alone, without family support, had a significantly greater dropout risk (odds ratio, 12.5; 95% confidence interval, 1.35Y11.6). Conclusions: For patients who live alone, an individualized approach may be better than a multidisciplinary management program, but this hypothesis should be investigated in future studies. KEY WORDS: ambulatory patients, chronic heart failure, dropout, Multidisciplinary Heart Failure Unity, nonadherence 475 Pablo Alvarez Rocha, MD Assistant Professor, Clinical Department of Medicine, Hospital de Clinicas de Montevideo, Uruguay. Gabriela Ormaechea, MD Assistant Professor, Clinical Department of Medicine, Hospital de Clinicas de Montevideo, Uruguay. Jorge Pouso, MD SNI Investigator, Clinical Department of Medicine, Hospital de Clinicas de Montevideo, Uruguay. Ignacio Batista, MD Assistant, Clinical Department of Medicine, Hospital de Clinicas de Montevideo, Uruguay. Virginia Estrago, MD Assistant, Clinical Department of Medicine, Hospital de Clinicas de Montevideo, Uruguay. Paola Ferna ´ ndez, MD Cardiologist, Department of Cardiology, Hospital de Clinicas de Montevideo, Uruguay. Lucia Florio, MD Assistant Professor, Clinical Department of Medicine, Hospital de Clinicas de Montevideo, Uruguay. Lidia Icasuriaga, SA Social Worker, Hospital de Clinicas de Montevideo, Uruguay. Patricia Mun ˜ iz, MD Psychiatrist, Hospital de Clinicas de Montevideo, Uruguay. Virginia Ortiz, MD Cardiologist, Hospital de Clinicas de Montevideo, Uruguay. Gabriel Parma, MD Resident, Clinical Department of Medicine, Hospital de Clinicas de Montevideo, Uruguay. Roberto Ricca, MD Assistant Professor, Clinical Department of Medicine, Hospital de Clinicas de Montevideo, Uruguay. Luz T. Rios Nurse, Hospital de Clinicas de Montevideo, Uruguay. Gabriela Silvera, MD Cardiologist, Hospital de Clinicas de Montevideo, Uruguay. Fernando Kuster, MD Assistant Professor, Clinical Department of Medicine, Hospital de Clinicas de Montevideo, Uruguay. Alfredo Alvarez Rocha, MD Professor and Director, Clinical Department of Medicine, Hospital de Clinicas de Montevideo, Uruguay. Ricardo Lluberas, MD Professor and Director, Department of Cardiology, Hospital de Clinicas de Montevideo, Uruguay. UMIC Group Corresponding author Pablo Alvarez Rocha, MD, Clinical Department of Medicine of Hospital de Clinicas ‘‘Dr Manuel Quintela,’’ Montevideo, Uruguay, Almiron 5495, Montevideo, Uruguay (dralvar@adinet.com.uy). 9 Copyright @ 200 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.