title: [Reduction in heart failure hospitalization rate during the first year of follow-up at a multidisciplinary unit].
abstract: OBJECTIVE
  Heart failure leads to frequent hospital readmissions. The aim of this study was to assess how receiving attention at our multidisciplinary unit influenced hospitalization for heart failure. We compared the number of admissions in the year preceding attendance with that in the first year of follow-up.
  
  
  METHODS
  In total, 366 patients were admitted between August 2001 and June 2003. Of these, 332 were still alive and could be assessed clinically 1 year later. The most common etiologies were ischemic heart disease in 60%, and dilated cardiomyopathy in 10%.
  
  
  RESULTS
  The number of admissions in the year preceding attendance was 246, while that during the first year of follow-up was 125, which corresponds to a statistically significant reduction of 49% (P<.001). The reduction was even greater (54%, P<.001), when only patients who were hospitalized more than once in the preceding year were analyzed. Moreover, in addition to the improvements noted during follow-up in patients' understanding of the disease and in several aspects of self-care, the increase in treatment use was also remarkable: beta-blocker use increased from 53% to 70%, spironolactone use from 20% to 30%, and statin use from 36% to 58%.
  
  
  CONCLUSIONS
  The number of hospital admissions for heart failure among patients who received attention at our multidisciplinary unit was significantly less in the first year of follow-up than in the year preceding attendance. This reduction was probably due to educational and pharmacologic interventions and to closer follow-up.
authors.affiliation: Unitat d'Insuficiència Cardíaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España. jlupon@ns.hugtip.scs.es
authors.forename: Josep
authors.initials: J
authors.lastname: Lupón
authors.forename: Teresa
authors.initials: T
authors.lastname: Parajón
authors.forename: Agustín
authors.initials: A
authors.lastname: Urrutia
authors.forename: Beatriz
authors.initials: B
authors.lastname: González
authors.forename: Juan
authors.initials: J
authors.lastname: Herreros
authors.forename: Salvador
authors.initials: S
authors.lastname: Altimir
authors.forename: Ramon
authors.initials: R
authors.lastname: Coll
authors.forename: Montserrat
authors.initials: M
authors.lastname: Prats
authors.forename: Vicente
authors.initials: V
authors.lastname: Valle
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000628:therapy*; D006757:Hospital Units; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors