Follow-up results in a specialized consultation after discharge for heart failure

Abstract

BackgroundDespite advances in the diagnosis and treatment of heart failure (HF), the condition still has high morbidity and mortality. Health education and the treatment of comorbidities have been shown to be effective, as has multidisciplinary care in specialized units, although this involves organizational and structural efforts that are not always feasible. We present the results of a simple outpatient consultation, focused on the specialized care of HF. Patients and methodsThe consultation included patients discharged after hospitalization (index hospitalization) for decompensated HF from an internal medicine department. The follow-up was conducted by internists especially dedicated (not exclusively) to HF and a nurse partially dedicated to HF. The follow-up consisted of fixed visits 1, 3, 6 and 12 months after the discharge, with more visits on demand if needed. ResultsA total of 250 patients were included with a minimum follow-up of 1 year. The reduction in hospitalisations and emergency department visits was 56% and 61% (p<.05), respectively, for HF and 46% and 40% (p<.05), respectively, for any cause. Treatment optimization was also achieved, with a significant increase in the evidence-based drug prescription rate and the reduction of other drugs, such as calcium antagonists. ConclusionA simple model based on a specialized care consultation for HF is effective in reducing readmissions and optimizing the treatment. The lack of healthcare resources should not be an obstacle for specialized care for patients with HF.