Document Detail


Improved outcomes from a comprehensive management system for heart failure.
MedLine Citation:
PMID:  11595611     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Congestive heart failure (CHF) is associated with a high readmission rate after diagnosis. We assessed the ability of a comprehensive management program (CMP) for CHF to reduce readmissions with secondary endpoints of improving quality of life, exercise capacity and targeted drug doses.
METHODS AND RESULTS: Patients (pts) with: New York Heart Association Class (NYHA) III or IV CHF; left ventricular ejection fraction <40%; and stable outpatient therapy were assigned to a CMP of cardiology assessment intensive education and referral to a tailored exercise program. Forty-two pts (35 M, 7 F, mean age 54 years, S.D. 12 years) were enrolled. Two pts were transplanted, two died during follow-up and two were lost to follow-up. Hospital admissions were reduced by 87.2%, (mean 1.05, S.D. 0.98, admissions per pt to mean 0.08, S.D. 0.28, admissions per pt at 6-month follow-up; P<0.0001). ACE-inhibitor dose increased by 42% (P<0.0008) and beta-blocker dose increased by 61% (P<0.0001). NYHA Class, 6-min walk and quality of life scores all improved significantly (P<0.0001).
CONCLUSION: A CMP improves QOL and exercise capacity as well as substantially reducing hospital admissions in CHF pts. This study validates the benefit of intensive outpatient care of CHF.
Authors:
D P Holst; D Kaye; M Richardson; H Krum; D Prior; A Aggarwal; R Wolfe; P Bergin
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of heart failure     Volume:  3     ISSN:  1388-9842     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2001-10-11     Completed Date:  2001-12-05     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  619-25     Citation Subset:  IM    
Affiliation:
Cardiovascular Medicine, Heart Centre, Alfred Hospital, Commercial Road, Prahran, Melbourne, Victoria 3181, Australia. d.holst@alfred.org.au
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MeSH Terms
Descriptor/Qualifier:
Aged
Chronic Disease
Disease Management*
Female
Heart Failure / rehabilitation*,  therapy
Humans
Male
Middle Aged
Outcome Assessment (Health Care) / methods*,  organization & administration
Patient Readmission / statistics & numerical data
Program Evaluation
Prospective Studies
Quality of Life
Severity of Illness Index

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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