Multidisciplinary Team Management in Heart Failure: Worth it? A Middle-Eastern Experience

Abstract

Background In recent years, there has been an emphasis on multidisciplinary team (MDT) care of the heart failure (HF) patient. A dedicated HF MDT was created on the 1stof January 2017 at Cleveland Clinic Abu Dhabi; consisting of HF cardiologists, clinical pharmacists and HF nurses. This study aims to assess the impact of a dedicated HF MDT on the mortality, length of stay and readmission rate in patients who are admitted with acute HF decompensation. Methods A retrospective review of the patients’ charts was conducted. We identified patients who were admitted for acute exacerbation of HF between the years 2015 and 2017. Group 1 consisted of 90 patients who were admitted prior to the creation of the HF MDT, while Group 2 consisted of 94 patients who were admitted after the establishment of the team. The groups were propensity-matched in order to account for any confounding variables between the two patient populations. Results Table 1 shows the baseline characteristics on admission of patients in both Group 1 and Group 2. The majority of patients in both groups had HFrEF. There were no significant differences between the two groups in terms of the baseline characteristics outlined. Table 2 highlights the differences in outcomes between the two groups. After the establishment of the HF MDT, there was a significant decrease in the 30 day readmission rate (25.84 % vs 5.98 %, P Conclusions Management of patients with HF by a dedicated HF MDT in the inpatient and outpatient setting results in a significant reduction in morbidity; with reduced 30-day readmission rates, length of stay in hospital, number of days for follow up post-discharge and the need for inotropic support.