Document Type

Article

Publication Date

Summer 8-1-2024

Journal

CJC Open

Volume

6

Issue

8

First Page

989

Last Page

1000

URL with Digital Object Identifier

10.1016/j.cjco.2024.03.015

Abstract

BACKGROUND: The management of heart failure (HF) is challenging because of the complexities in recommended therapies. Integrated disease management (IDM) is an effective model, promoting guideline-directed care, but the impact of IDM in the community setting requires further evaluation.

METHODS: A retrospective evaluation of community-based IDM. Patient characteristics were described, and outcomes using a pre- and post-intervention design were HF-related health-service use, quality of life, and concordance with guideline-directed medical therapy (GDMT).

RESULTS: 715 patients were treated in the program (2016 to 2023), 219 in a community specialist-care clinic, and 496 in 25 primary-care clinics. The overall cohort was predominantly male (60%), with a mean age of 73.5 years (± 10.7), and 60% with HF with reduced ejection fraction. In patients with ≥ 6 months of follow-up (n = 267), pre vs post annualized rates of HF-related acute health-service use decreased from 36.3 to 8.5 hospitalizations per 100 patients per year,

CONCLUSIONS: A community-based IDM program for HF, may reduce HF-related acute health-service use, improve quality of life and level of concordance with GDMT. These encouraging preliminary outcomes from a real-world program evaluation require confirmation in a randomized controlled trial.

Notes

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

Citation of this paper:

Licskai C, Hussey A, Ferrone M, Faulds C, Fisk M, Narayan S, O'Callahan T, Scarffe A, Sibbald S, Singh D, To T, Tuomi J, McKelvie R. An Innovative Patient-Centred Approach to Heart Failure Management: The Best Care Heart Failure Integrated Disease-Management Program. CJC Open. 2024 Apr 10;6(8):989-1000. doi: 10.1016/j.cjco.2024.03.015. PMID: 39211747; PMCID: PMC11357758.

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