An inpatient multidisciplinary educational approach to reduce 30-day heart failure readmissions

Despite dramatic improvements in the management of heart failure (HF), hospital readmissions due to HF exacerbation remain high. To improve quality of care, many hospitals have developed interventions to reduce HF readmission rates. The aim of this study was to evaluate the impact of an inpatient multidisciplinary educational approach utilizing pharmacist to reduce 30-day HF readmissions.

Retrospective observational study conducted at a tertiary-hospital in Tucson-Arizona, USA. It included adult patients admitted with a documented diagnosis of HF and excluded patients discharged to hospice. Patents were divided into two groups: intervention and control group. Intervention components included: (1) pharmacy student counseling; (2) HF education provided jointly by a pharmacist and a nurse as a group class to patients and caregivers and/or one-on-one education with a nurse; and (3) follow-up phone calls 1-3 days post-discharge reinforcing HF education. The main outcome was the rate of hospital readmission within 30 days post HF discharge.

A total of 221 patients were identified in the intervention and 183 in the control groups. Of the patients in the intervention group, 44.8% received pharmacy student counseling, 47.1% received HF education, 25.3% were contacted 1-3 days post-discharge; and 5% received all intervention components. The difference in the primary outcome was not statistically different, with 3.8% readmission rate in the control group compared to 4.5% in the intervention group (p = 0.73). It is worth to notice that none of the 11 patients who received all components of the interventions were readmitted. Univariate analysis demonstrated a significant association between pharmacy student counseling and 30-day HF readmissions (p = 0.03); however, no difference was observed after adjusting for all variables.

The readmission rate in both groups was below national rate, and neither the intervention nor components were associated with a significant reduction in the primary outcome. Another study is needed to assess the rate of HF readmission in patients receiving all components of the multidisciplinary interventions.