Managing patients with heart failure: contemporary real-world experience

Abstract

Objective Heart failure (HF) is a chronic disease with growing numbers of patients and a significant compromise in quality of life and high mortality. The main purpose of this study was to evaluate the current practices in managing patients with HF among patients admitted to the hospital and discharged with a primary diagnosis of HF and patients managed in the heart function clinic. Results This study is a retrospective chart review of patients admitted to the hospital and discharged with a primary diagnosis of HF. A total of 448 patient charts were reviewed, of which 173 patients were in the hospital group and 275 patients in the Clinic group. 278 (62.1%) were men, and 170 (37.9%) were women. The Clinic group of patients were significantly received guideline-directed medical therapy (Beta-blockers, Angiotensin-converting enzyme inhibitors, Angiotensin receptor blockers, Diuretics, Mineralocorticoid receptor antagonists—p < 0.001). The Clinic group of patients (17.1%) were significantly less re-hospitalized (p < 0.001) compared to the Hospital group (28%) at 180 days. Physician led multidisciplinary Heart function clinics have better adherence to guideline directed medical therapy and significantly lower rates of re-hospitalization thereby providing cost effective heart failure management with usual care.

Factores asociados a mortalidad intrahospitalaria en falla cardiaca aguda

“…Por lo anterior, es preciso decir que en países desarrollados la mortalidad intrahospitalaria es menor, probablemente debido a la robustez de su sistema de salud, así como a la presencia extensiva en estos países de unidades especializadas para el manejo y la atención de esta patología, que aseguran un seguimiento periódico, una mejor adherencia a la terapia farmacológica y no farmacológica de estos pacientes, con el fin de disminuir los ingresos hospitalarios por esta causa ,estas unidades con programa para pacientes con FC también propenden por una mayor educación en cuanto a la detección de signos de alarma para acudir tempranamente a los servicios de urgencias y así disminuir complicaciones (9,26,29,30).…”

Factors Affecting Referral and Patient Access to Heart Function Clinics in Ontario: A Qualitative Study of Stakeholders

“…Some clinics are more specific to assessment for devices or advanced transplantation candidacy, for example. HFCs have been shown to reduce HF-related mortality by 10%-15%, HF-related hospitalizations by 30%-56% and all-cause readmissions by 15%-25%, 13 , 14 and also to be cost-effective. 15 Therefore, guidelines from major cardiac societies globally recommend referral to these clinics, although no consensus has been reached on referral criteria regarding which patients would be best served.…”