A Heart Failure Management Program Using Shared Medical Appointments.

Area of Science:

• Cardiology
• Health Services Research
• Veteran Health

Background:

• Heart failure (HF) disease management programs reduce hospitalizations and mortality.
• Shared medical appointments (SMAs) are a cost-effective method for HF management.
• Few studies have assessed HF-SMAs for Veterans with acute HF.

Purpose of the Study:

• To evaluate if multidisciplinary HF-SMAs improve 12-month hospitalization outcomes for Veterans with acute HF compared to standard HF specialty care.
• To test the hypothesis that HF-SMAs enhance HF self-management and reduce hospitalizations.

Main Methods:

• Retrospective review of VA electronic health records from 2012-2013.
• Compared 54 Veterans attending a 4-week multidisciplinary HF-SMA program to 37 Veterans receiving standard HF clinic care.
• Assessed 12-month HF-related and all-cause hospitalizations, hospital days, and time to first hospitalization.

Main Results:

• No significant differences in sociodemographic variables between the HF-SMA and HF clinic groups.
• No significant differences in 12-month hospitalization outcomes (HF-related, all-cause, hospital days, time to hospitalization) between the groups.
• p > .05 for all comparisons.

Conclusions:

• The study did not support the hypothesis that HF-SMAs improve hospitalization outcomes for Veterans with acute HF beyond standard care.
• Limitations include the retrospective design and specific program structure.
• Recommendations for optimizing HF self-management programs for Veterans are discussed.