Abstract P175: Shared Medical Appointments in Heart Failure for Post-Hospitalization Follow-Up

Abstract

Introduction: Shared medical appointments (SMAs) are medical visits where several patients with a common disease have clinic at the same time with medical provider(s). SMAs in heart failure (HF) is a unique opportunity where providers of different disciplines, one of which is a prescriber with HF expertise, can improve the health of patients recently discharged with HF. Hypothesis: Compared with usual care, patients discharged with HF randomized to a HF-SMA will experience better cardiac health status as measured by Kansas City Cardiomyopathy Questionnaire (KCCQ) and overall health status as measured by the EQ-5D Visual Analog Scale (EQ5D-VAS) Methods: We conducted a 3-site open label randomized-controlled trial of parallel design. Participants within 12 weeks of a HF hospitalization were randomized to receive either HF-SMA versus usual care. The HF-SMA team consisted of a nurse, nutritionist, psychologist, nurse practitioner and/or a clinical pharmacist and included four 2 hour sessions that met every other week for 8 weeks. Primary outcomes are overall health status measured by EQ5D-VAS (range 0-100 with 0 = worst health and 100 = Best health) and cardiac health status by KCCQ (range 0-100, higher score is better cardiac health), after 180 days post randomization. Results: Of the 242 patients enrolled (mean age 69.3±9.4 years, 71.5% white, 94.6% male), 83.8% HF-SMA and 84.8% usual care participants completed the study. Although both groups had significant improvements from baseline in their overall health status, patients in the HF-SMA intervention experienced a greater improvement in EQ5D-VAS scores than usual care (change = 7.2 ± 15.8 versus -0.4 ± 19.0 points, p<0.001, respectively). There were no significant differences between the groups in the cardiac health status KCCQ Summary or Clinical Scores. Conclusion: HF-SMA achieved higher Improvements in overall health status than usual care but not in cardiac health status. Future studies should power to compare data on event outcomes to better understand impact.