Comparison of 18-Month Outcomes of Ambulatory Patients With Reduced (≤40%) Left Ventricular Ejection Fraction Treated in a Community-Based, Dedicated Heart Failure Clinic Versus Treated Elsewhere

Heart Function Clinics for Patients With Heart Failure

“…The clinical outcomes considered in the primary clinical studies included hospitalization, [9][10][11]13 mortality, 9,12,13 guideline-directed medical therapy, 9,10,12 improvement in ejection fraction, 9 primary care and emergency department visits, 10 and medication adherence. 14 The follow-up periods among the included studies ranged from 3 months to 2 years.…”

“…The 6 included primary clinical studies comprised 1 prospective cohort study 12 and 5 retrospective cohort studies. [9][10][11]13,14 The studies were published between 2017 and 2020.…”

“…The primary clinical studies were conducted by authors from India, 9 Israel, 10,12 and the US. 11,13,14 The economic evaluation studies were conducted by author(s) from Denmark 15 and Canada.…”

“…Three retrospective cohort studies [9][10][11] and 1 prospective cohort study 12 compared multidisciplinary HF clinics with usual care. One retrospective cohort study 13 compared data from a multidisciplinary HF clinic with the Centers for Medicare & Medicaid Services (CMS) data for the national average and surrounding area hospitals, while the other retrospective cohort study 14 compared data of patients attending a multidisciplinary HF clinic with historical controls who did not attend the HF clinic.…”

“…Despite differences in baseline patient characteristics between groups in all included studies, only 2 studies 10,14 adjusted for potential confounders in the analysis, while the other 4 studies did not. 9,[11][12][13] None of studies provided sample size calculations and therefore it was unclear if the studies had sufficient power to detect a statistically significant effect where the P value for a difference being due to chance is less than 5%. Overall, the methodological quality of the included studies was low.…”