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Lessons learned from a multidisciplinary heart failure clinic for older women: a randomised controlled trial

Nahid Azad1, Frank Molnar, Anna Byszewski

  • 1The Geriatric Assessment Inpatient Unit, The Ottawa Hospital, Ottawa, Ontario, K1Y 4E9, Canada. nazad@ottawahospital.on.ca

Age and Ageing
|February 21, 2008
PubMed

Insights

A multidisciplinary clinical pathway for heart failure (HF) in older women did not improve quality of life or function. However, the approach was feasible for future research in HF disease management.

Area of Science:

  • Cardiology
  • Geriatrics
  • Health Services Research

Background:

  • Heart failure disease management programs are underrepresented in the female population.
  • A multidisciplinary approach in a standardized clinical pathway warrants investigation for older women with heart failure (HF).

Purpose of the Study:

  • To investigate the effectiveness of a multidisciplinary clinical pathway for older women with HF.
  • To assess the feasibility of a randomized controlled trial in this demographic.

Main Methods:

  • A randomized controlled trial involving 91 community-dwelling female patients (aged 63-89) with HF.
  • Intervention group received a 6-week multidisciplinary pathway (12 outpatient visits).
  • Outcomes measured by the Minnesota Living with Heart Failure Questionnaire and Physical Self-Maintenance Scale.

Main Results:

  • No significant difference in quality of life (Minnesota Living with Heart Failure Questionnaire) between groups.
  • No significant difference in functional outcomes (Physical Self-Maintenance Scale) between groups.
  • The intervention group experienced significantly more hospitalizations and cardiologist visits (P < 0.0001).

Conclusions:

  • A complex, multidisciplinary HF management pathway is feasible to test in frail, community-based older women.
  • Future research should focus on optimizing the intensity and duration of HF management programs for targeted populations.
Abstract

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