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Efficacy of community-based multidisciplinary disease management of chronic heart failure

A R Omar1, N Suppiah, P Chai

  • 1Department of Cardiology, National University Hospital, Singapore. abdul_razakjr_bin_omar@nuh.com.sg

Singapore Medical Journal
|June 1, 2007
PubMed

Insights

A multidisciplinary disease management program for chronic heart failure (CHF) significantly improved patient quality of life and reduced hospitalizations in an Asian community. This approach enhanced care quality and showed no mortality over six months.

Area of Science:

  • Cardiology
  • Public Health
  • Geriatrics

Background:

  • Chronic heart failure (CHF) management programs improve outcomes, but their efficacy in diverse Asian populations is not well-established.
  • Multidisciplinary disease management (DM) aims to optimize care for patients with complex chronic conditions like CHF.
  • Evaluating community-based DM programs is crucial for understanding their impact on heterogeneous patient groups.

Purpose of the Study:

  • To evaluate the efficacy of a multidisciplinary, community-based disease management program for chronic heart failure (CHF) in a heterogeneous Asian population.
  • To assess the program's impact on clinical outcomes, quality of life, activity status, and quality of care.
  • To determine the program's effect on CHF hospitalisation rates and patient mortality.

Main Methods:

  • A prospective study involving 154 patients diagnosed with New York Heart Association functional class III/IV CHF and left ventricular ejection fraction (LVEF) < 40%.
  • Patients had a mean age of 65 ± 12 years and a mean LVEF of 27 ± 9%.
  • Outcomes assessed at six months included CHF hospitalisation, quality of life, activity status, and quality of care (use of ACE inhibitors/ARBs and beta-blockers).

Main Results:

  • Significant improvements observed in quality of life and activity status (p < 0.001) after six months.
  • High adherence to ACE inhibitors/angiotensin receptor blockers (ARBs) (97%) and increased use of beta-blockers (p=0.001).
  • A 68% reduction in CHF hospitalisation rate (p < 0.001) with no reported mortality.

Conclusions:

  • Multidisciplinary DM for CHF in a heterogeneous Asian community leads to significant improvements.
  • The program enhanced patient quality of life and quality of care, including medication adherence.
  • A notable reduction in CHF hospitalisation rates was achieved, highlighting the program's effectiveness.
Abstract

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