Cardiac outreach services reduce mortality and readmissions.

Area of Science:

• Cardiology
• Public Health
• Health Services Research

Background:

• Heart failure (HF) remains a leading cause of morbidity and mortality globally.
• Despite advancements, HF patient outcomes require improvement through non-pharmacological interventions.
• The study addresses the need for enhanced HF management strategies.

Purpose of the Study:

• To assess the impact of a heart failure (HF) outreach program.
• To evaluate the program's effect on mortality, HF hospitalizations, and guideline-directed medical therapy (GDMT) adherence.
• To determine the effectiveness of HF outreach in South-Western Sydney Local Health District (SWSLHD).

Main Methods:

• Observational, registry-based study of adult patients with HF with reduced ejection fraction (HFrEF).
• Inclusion criteria: diagnosis of HFrEF in SWSLHD, participation in HF outreach service (March 2011-January 2016).
• Primary outcome: all-cause mortality; Secondary outcomes: optimal GDMT rate, HF hospitalizations.

Main Results:

• Enrolled patients (n=470) showed significantly lower mortality (26% vs 38.2%, p<0.001) compared to non-enrolled (n=348).
• Fewer hospital admissions for HF (>3 admissions: 16.2% vs 35.6%, p<0.001) and reduced admission days were observed in the enrolled group.
• Enrolled patients had higher rates of optimal GDMT (76.6% vs 56.6%, p<0.001).

Conclusions:

• HF outreach program enrollment is linked to reduced mortality and HF hospital admissions.
• The program significantly increases the likelihood of patients receiving optimal guideline-directed medical therapy (GDMT).
• HF outreach programs are recommended for routine management of HFrEF patients due to high HF prevalence.