A Systematic Meta-Analysis of the Efficacy and Heterogeneity of Disease Management Programs in Congestive Heart Failure

Göhler, Alexander; Januzzi, James L.; Worrell, Stewart S.; Osterziel, Karl Josef; Gazelle, G. Scott; Dietz, Rainer; Siebert, Uwe

doi:10.1016/j.cardfail.2006.03.003

Cited by 147 publications

(130 citation statements)

References 56 publications

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“…2 Heart failure disease management programmes can reduce readmission rates and mortality. 3,4 Although the interventions vary, a multi-disciplinary team approach with specialist heart failure nurses playing a pivotal role in monitoring signs and symptoms, optimizing medication, providing education, co-ordinating care, and facilitating self-care is now recommended in international guidelines. 5,6 Replicating these multi-disciplinary interventions in routine practice is challenging, as many elderly patients are not able to attend frequent clinic visits, there are a limited number of specialist nurses, and a limit on the number of patients with whom they can maintain frequent contact.…”

Section: Introductionmentioning

confidence: 99%

A randomized trial of home telemonitoring in a typical elderly heart failure population in North West London: results of the Home‐HF study

Dar

Riley

Chapman

et al. 2009

European J of Heart Fail

128

217

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Aims Heart failure chiefly affects the elderly, with frequent emergency admissions. Telemonitoring can identify worsening heart failure but previous randomized trials have enrolled selected patient populations. The Home‐HF study examined the impact of home telemonitoring on typical heart failure patients discharged from three acute hospitals in North West London, UK. Methods and results Patients hospitalized with heart failure were randomized to telemonitoring or usual specialist care. Primary outcome measures were days alive and out of hospital. Secondary outcome measures were number and duration of heart failure hospitalizations, clinic visits, and quality of life. We recruited 182 patients. There was no difference in the primary outcome measure in the two groups, but there were significantly fewer unplanned hospitalizations for heart failure decompensation, and a reduction in clinic and emergency room visits in the telemonitoring group. There was no statistically significant difference in the mean direct health service costs. Conclusion Home telemonitoring in a typical elderly population of heart failure patients produces a similar outcome to ‘usual’ specialist care, but reduces clinic and emergency room visits and unplanned heart failure rehospitalizations at little additional cost. This method of disease monitoring may allow specialist services to increase the number of patients under their care.

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Section: Introductionmentioning

confidence: 99%

A randomized trial of home telemonitoring in a typical elderly heart failure population in North West London: results of the Home‐HF study

Dar

Riley

Chapman

et al. 2009

European J of Heart Fail

128

217

View full text Add to dashboard Cite

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“…Early rehospitalization is more frequent during the first month (around 20%) and further compromises prognosis 2 . As a consequence, the impact on the budget A critical review on telemonitoring in heart failure Olivier GURNÉ 1 , MD, PhD; Viviane CONRAADS 2 , MD, PhD; Luc MISSAULT 3 , MD, Wilfried MULLENS 4 , MD, PhD; Jean-Luc VACHIERY 5 , MD, PhD, Walter VAN MIEGHEM 4 , MD, PhD, Walter DROOGNE 6 , MD; Anne-Catherine POULEUR 1 , MD, PhD; Pierre TROISFONTAINE 7 , MD; Sandrine HUEZ 5 , MD; Eric NELLESSENS 8 , MD; Béatrice PEPERSTRAETE 9 , MD; Philippe BLOUARD 10 , MD ; Johan VANHAECKE 6 , MD, PhD; David RAES 11 , MD for the Belgian Working Group on Heart Failure 1 Cliniques Universitaires St Luc, Bruxelles, Belgium; 2 UZ Antwerpen, Edegem, Belgium; 3 AZ St Jan, Brugge, Belgium; 4 Ziekenhuis Oost Limburg, Genk, Belgium; 5 Hôpital Erasme, Bruxelles, Belgium; 6 UZLeuven, Leuven, Belgium; 7 CHR Citadelle, Liège, Belgium; 8 CHU Sart Tilman, Liège, Belgium; 9 CHU Brugmann, Bruxelles, Belgium; 10 Clinique St Luc, Bouge, Belgium; 11 GZA Sint Augustinus, Wilrijk, Belgium.…”

Section: Introductionmentioning

confidence: 99%

“…A multidisciplinary approach coordinating care along the continuum of HF and throughout the chain of care delivery, mainly through direct health-care providers and patient contacts, has been largely validated 4,5 and incorporated in both American and European guidelines 6,7 . However, these management strategies have tested multi-disciplinary approaches incorporating heart failure clinics.…”

Section: Introductionmentioning

confidence: 99%

A critical review on telemonitoring in heart failure

Gurné

Conraads²,

Missault

et al. 2012

Acta Cardiologica

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“…Although the COACH study [3] has shown that the optimal model of HF disease management is not known yet, other studies have revealed that multidisciplinary HF disease management programs can be effective in terms of improving patient adherence, decreasing hospital readmission and mortality [4][5][6] and are now generally accepted as standard care [7][8][9]. Most of these studies evaluated hospital based (outpatient) disease management.…”

Section: Introductionmentioning

confidence: 99%

Design and methodology of the COACH-2 (Comparative study on guideline adherence and patient compliance in heart failure patients) study: HF clinics versus primary care in stable patients on optimal therapy

et al. 2012

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Background Since the number of heart failure (HF) patients is still growing and long-term treatment of HF patients is necessary, it is important to initiate effective ways for structural involvement of primary care services in HF management programs. However, evidence on whether and when patients can be referred back to be managed in primary care is lacking. Aim To determine whether long-term patient management in primary care, after initial optimisation of pharmacological and non-pharmacological treatment in a specialised HF clinic, is equally effective as long-term management in a specialised HF clinic in terms of guideline adherence and patient compliance. Method The study is designed as a randomised, controlled, non-inferiority trial. Two-hundred patients will be randomly assigned to be managed and followed in primary care or in a HFclinic. Patients are eligible to participate if they are (1) clinically stable, (2) optimally up-titrated on medication (according to ESC guidelines) and, (3) have received optimal education and counselling on pre-specified issues regarding HF and its treatment. Furthermore, close cooperation between secondary and primary care in terms of back referral to or consultation of the HF clinic will be provided.The primary outcome will be prescriber adherence and patient compliance with medication after 12 months. Secondary outcomes measures will be readmission rate, mortality, quality of life and patient compliance with other lifestyle changes. Expected results The results of the study will add to the understanding of the role of primary care and HF clinics in the long-term follow-up of HF patients.

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A Systematic Meta-Analysis of the Efficacy and Heterogeneity of Disease Management Programs in Congestive Heart Failure

Cited by 147 publications

References 56 publications

A randomized trial of home telemonitoring in a typical elderly heart failure population in North West London: results of the Home‐HF study

A randomized trial of home telemonitoring in a typical elderly heart failure population in North West London: results of the Home‐HF study

A critical review on telemonitoring in heart failure

Design and methodology of the COACH-2 (Comparative study on guideline adherence and patient compliance in heart failure patients) study: HF clinics versus primary care in stable patients on optimal therapy

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