Heart failure programmes reduce hospitalizations
Heart failure (HF) programmes designed to optimize delivery of guideline-recommended care and provide self-care support to patients have been shown to reduce hospitalizations.
A HF model of care, comprising electronic HF care bundles, a patient education pack with education delivered by trained staff, referral of patients to a Hospital Admission Risk Programme for phone call within 72 hours, and an early follow-up clinic co-led by nurses and pharmacists, was implemented at an Australian hospital to reduce variations in delivery of guideline-recommended HF care. [Intern Med J 2020, doi: 10.1111/imj.14783]
Implementation of this model of care resulted in significant reductions in 30-day (7.8 percent; p=0.018) and 90-day (9.4 percent; p=0.001) readmissions as well as the overall trend of 90-day readmissions (-0.6 percent per month; p=0.017), without increasing emergency department presentations, inpatient mortality or length of hospital stay.
In a Canadian study, a telemonitoring programme implemented as part of standard of care at an outpatient heart function clinic was found to reduce HF-related hospitalizations by 50 percent (p<0.001) and all-cause hospitalizations by 24 percent (p=0.02) at 6 months after vs 6 months before programme enrolment. B-type natriuretic peptide levels decreased by 59 percent at 6 months. [J Med Internet Res 2020, doi: 10.2196/16538]
Patients participating in the telemonitoring programme used a mobile phone to record daily HF readings and received personalized self-care messages generated by a clinically validated algorithm. Alerts were also generated and immediately acted upon by the care team as needed. Significant improvements in the patients’ quality of life and self-care were shown at 6 months.