Are There Benefits for Patients Attending ‘A Heart Failure Clinic'? A Five Year Review

Abstract

Objective To determine the effects of attendance at a chronic ‘heart failure clinic', with emphasis on patient education on morbidity, hospitalisations and mortality associated with heart failure due to left ventricular systolic dysfunction. Design Retrospective case audit study. Setting University hospital with a primary catchment area of 500,000 inhabitants. Patients 100 patients (aged 54–87 years, 59% male) with a confirmed diagnosis of left ventricular systolic dysfunction. Methods Patients regularly reviewed at a ‘heart failure clinic’ where emphasis was placed on optimisation of drug therapy, patient education, self-management, and adherence to treatment regimes. Results The median age of the study population was 72 (50–87 years), 89% had a current NYHA status of III/IV. The average dose of frusemide was 111mg/day, with 74% of the study group receiving an ACE inhibitor and 15% an angiotensin II antagonist or vasodilator. Hospitalisation rate was 0.7±0.1 admissions per patient per year, the length of stay during admission was 11.8±2 days (females) and 10.5±2.2 days (males), and the average length of survival from first clinic attendance was 5.3±1.75 years for females and 2.97±0.5 years for males. Conclusions Attendance at a ‘heart failure clinic’ ensures optimisation of medication, reduction of patient admission rate and duration of hospitalisation.