Group medical visits after heart failure hospitalization: Study protocol for a randomized-controlled trial

Wu, Wen‐Chih; Parent, Melanie; Dev, Sandesh; Hearns, Rene; Taveira, Tracey H.; Cohen, Lisa; Shell-Boyd, Jeneen; Jewett-Tennant, Jeri; Marshall, Vanessa; Gee, Julie; Schaub, Kimberley; LaForest, Sharon; Ball, Sherry L.

doi:10.1016/j.cct.2018.06.015

Cited by 6 publications

(3 citation statements)

References 39 publications

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“…Details of the trial design have been previously published. 10 This trial was registered with Clinicaltrials.gov public database, a registry and results database of publicly and privately supported clinical studies of human participants (ClinicalTrials.gov Identifier: NCT02481921). The Institutional Review Board and Research and Development Committees at the Providence, Phoenix, and Cleveland Veterans Affairs Medical Centers approved the protocol.…”

Section: Methodsmentioning

confidence: 99%

Shared Medical Appointments in Heart Failure For Post-hospitalization Follow-up: A Randomized Controlled Trial

Taveira,

Cohen,

Laforest

et al. 2024

Preprint

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Background: Shared medical appointments (SMAs) in heart failure (HF) are medical visits where several patients with HF meet with multidisciplinary providers at the same time for efficient and comprehensive care. It is unknown whether HF-SMAs can improve overall and cardiac health status for high-risk patients discharged with HF. Methods: A 3-site, open-label, randomized-controlled-trial was conducted. Participants within 12 weeks of HF hospitalization were randomized to receive either HF-SMA or usual HF clinical care (usual-care) on a 1:1 ratio. The HF-SMA team, which consisted of a nurse, nutritionist, psychologist, nurse practitioner and/or a clinical pharmacist, provided four 2-hour session HF-SMAs that met every other week for 8 weeks. Primary outcomes were the overall health status measured by EQ5D-VAS and cardiac health status by KCCQ, 180 days post-randomization. Results: Of the 242 patients enrolled (HF-SMA n=117, usual-care n=125, mean age 69.3±9.4 years, 71.5% white, 94.6% male), 84% of participants completed the study (n=8 HF-SMA and n=9 usual-care patients died). After 180 days, both HF-SMA and usual-care participants had similar and significant improvements from baseline in KCCQ, but only HF-SMA participants had significant improvements in EQ5D-VAS (mean change = 7.2 +/- 15.8 in HF-SMA versus -0.4 +/- 19.0 points in usual-care, p<0.001). Conclusion: Both HF-SMA and usual care in HF participants achieved significant improvements in cardiac health status, but only a team approach through HF-SMA achieved significant improvements in overall health status. A larger population and a longer follow-up time are needed in future studies to evaluate re-hospitalization and death outcomes.

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Section: Methodsmentioning

confidence: 99%

Shared Medical Appointments in Heart Failure For Post-hospitalization Follow-up: A Randomized Controlled Trial

Taveira,

Cohen,

Laforest

et al. 2024

Preprint

Self Cite

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“…This qualitative study was a portion of a VHA three-site randomized control trial (RCT) to study outcomes associated with the use of SMAs following hospitalization for HF [13]. The…”

Section: Methodsmentioning

confidence: 99%

“…Patients were referred to HF SMAs by either a physician, nurse, clinical pharmacist, physician assistant or nurse practitioner that were adapted to include consistent patient education. Further details of the HF SMA self-care topics and appointment protocol have been previously published [13].…”

Section: Settingmentioning

confidence: 99%

Healthcare providers experiences with shared medical appointments for heart failure

et al. 2022

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Shared medical appointments (SMAs) offer a means for providing knowledge and skills needed for chronic disease management to patients. However, SMAs require a time and attention investment from health care providers, who must understand the goals and potential benefits of SMAs from the perspective of patients and providers. To better understand how to gain provider engagement and inform future SMA implementation, qualitative inquiry of provider experience based on a knowledge-attitude-practice model was explored. Semi-structured interviews were conducted with 24 health care providers leading SMAs for heart failure at three Veterans Administration Medical Centers. Rapid matrix analysis process techniques including team-based qualitative inquiry followed by stakeholder validation was employed. The interview guide followed a knowledge-attitude-practice model with a priori domains of knowledge of SMA structure and content (understanding of how SMAs were structured), SMA attitude/beliefs (general expectations about SMA use), attitudes regarding how leading SMAs affected patients, and providers. Data regarding the patient referral process (organizational processes for referring patients to SMAs) and suggested improvements were collected to further inform the development of SMA implementation best practices. Providers from all three sites reported similar knowledge, attitude and beliefs of SMAs. In general, providers reported that the multi-disciplinary structure of SMAs was an effective strategy towards improving clinical outcomes for patients. Emergent themes regarding experiences with SMAs included improved self-efficacy gained from real-time collaboration with providers from multiple disciplines, perceived decrease in patient re-hospitalizations, and promotion of self-management skills for patients with HF. Most providers reported that the SMA-setting facilitated patient learning by providing opportunities for the sharing of experiences and knowledge. This was associated with the perception of increased comradery and support among patients. Future research is needed to test suggested improvements and to develop best practices for training additional sites to implement HF SMA.

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Social network interventions to support cardiac rehabilitation and secondary prevention in the management of people with heart disease

Purcell

Dibben

Boon

et al. 2023

Cochrane Database of Systematic Reviews

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Group medical visits after heart failure hospitalization: Study protocol for a randomized-controlled trial

Cited by 6 publications

References 39 publications

Shared Medical Appointments in Heart Failure For Post-hospitalization Follow-up: A Randomized Controlled Trial

Shared Medical Appointments in Heart Failure For Post-hospitalization Follow-up: A Randomized Controlled Trial

Healthcare providers experiences with shared medical appointments for heart failure

Social network interventions to support cardiac rehabilitation and secondary prevention in the management of people with heart disease

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