The Effect of a Nurse-Driven Program Utilizing Implantable Pulmonary Artery Pressure Monitoring to Reduce Hospitalizations in Low-Socioeconomic Urban Patients with Heart Failure

Abstract

Background Hospitalizations in patients with heart failure (HF) remain high despite advances in treatment. While implantable pulmonary artery pressure monitors (Abbott CardioMEMS) reduce readmissions in largely white and male cohorts, their efficacy in poor, minority populations are not known. We hypothesized that a nurse-driven program using the CardioMEMS device could reduce HF hospitalizations in such patients. Methods 22 high-utilizing patients (86% non-white, 55% female) with NYHA Class III HF were implanted with a CardioMEMS following a hospital admission for HF. Data from the CardioMEMS guided a speciallytrained nurse in adjusting medications. Enrolled patients were matched using 30 clinical and demographic variables with contemporaneous control HF patients who received usual care. Each patient's hospitalizations were recorded for 6 months and compared using Fisher's exact test. Results Patients who received a CardioMEMS experienced a 61% decrease in HF-related readmission and a 70% reduction in HF-related ED visits (p Conclusion A nurse-driven CardioMEMS program reduces HF-related hospitalization and ED visits among high-risk, low-socioeconomic, urban patients.