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Prospective evaluation of an outpatient heart failure management program
R E Hershberger1, H Ni, D J Nauman
1Oregon Heart Failure Project, Heart Failure Treatment Program, Oregon Health Sciences University, Portland, Oregon 97201-3098, USA.
Journal of Cardiac Failure
|March 27, 2001
Summary
This heart failure outpatient management program significantly improved patient self-care and quality of life. It reduced hospitalizations by 52% and emergency room visits by 72% in heart failure patients.
Area of Science:
- Cardiology
- Public Health
- Health Services Research
Background:
- The effectiveness of outpatient management for heart failure requires further demonstration.
- Hospitalized patient follow-up has received considerable attention, but outpatient strategies are less understood.
Purpose of the Study:
- To evaluate the effectiveness of a comprehensive heart failure outpatient management program.
- To assess the impact of the program on patient quality of life, self-care behaviors, and clinical outcomes.
Main Methods:
- A prospective study of 108 new heart failure patients referred to an outpatient program.
- Data collected at baseline, 3 months, and 6 months included quality of life (QOL) and self-care adherence.
- Clinical outcomes (hospitalizations, ER visits) were compared for 6 months pre- and post-referral.
Main Results:
- Patient self-care knowledge scores improved (P <.01), and daily weighing increased by 24% (P =.02).
- New York Heart Association (NYHA) class III-IV patients decreased from 67.6% to 49.1% (P =.01).
- Hospitalizations for cardiovascular causes reduced by 52% (P <.001), and ER visits by 72% (P <.01). QOL improved significantly (P <.001).
Conclusions:
- The studied heart failure outpatient management program is effective.
- The program demonstrated significant improvements in patient self-care, QOL, and clinical outcomes, including reduced hospitalizations and ER visits.