An Evaluation of Pharmacist-Led Heart Failure Clinic in Tan Tock Seng Hospital

Abstract

diagnosis within 180 days. The unnecessary utilization of health care resources justified tests of change to improve self-management of HF. We tested a behavioral element of health care: will better disease-specific knowledge lead to successful self management of HF?Methods: This study assessed outcomes in the self-management of HF among admitted HF patients given intensive education and care coordination compared to usual care. Study population comprised hospitalized patients with HF discharged to their homes and without cognitive deficits. Patients randomly admitted cardiology teams and general medicine teams formed the intervention group; all other HF patients formed the usual care group. During their hospitalization, intervention patients received enhanced education and earlier scheduled primary care appointments compared to the control group, who had standard HF education. Within 2-4 days of discharge, study patients received a follow-up phone call to enhance care coordination and assess patient self-management of heart failure. Data were analyzed using Fisher ‘s exact test and t-tests. Mean, standard deviation, and proportions were used to characterize the study sample, using a p-value !0.05 for statistical significance. Results: The study contained 40 HF patients with 20 in each study group. Study participants were 96.97% male, 72.73% white, 81.82% non-Hispanic, average age 65.6 years, and 60.6% had a history of smoking. Intervention patients were more likely to have a scale at home, weigh themselves every day, and record their weight (p!0.05). Intervened patients were also 1.69 times more likely than control patients to understand the adverse consequences of a diet high in sodium (p50.08). Conclusion: This health system’s first step in evidence based redesign of care coordination for HF patients examined enhanced inpatient care coordination. Patients receiving more intensive education knew more about their disease and were better able to self-manage their weight compared to those receiving standard care. The results of this study, in addition to qualitative findings from study participants’ focus groups, will help us further to tailor interventions to the patients’ explicit needs.