[Evaluation of a multidisciplinary management by a health care network for patients with chronic heart failure].
OBJECTIVE
To evaluate the impact, at three months, of a multidisciplinary management by a health care network for patients with chronic heart failure, compared with a historic control group.


METHODS
We carried out an exhaustive prospective investigation of 68 patients included in the network in 2001 (stage II to IV of NYHA classification). The historic control was 64 patients hospitalized in 2000 with the same inclusion criteria.


RESULTS
Mean age (78 years) and the initial severity of heart failure (stage NYHA II: 43%, III: 55%, IV: 2%) did not differ between the two groups. Seven parameters significantly improved at three months in intervention group: systolic blood pressure, heart frequency, walking distance covered in six minutes, quality of life score, prescription of angiotensin converting enzyme inhibitor at maximal dose, prescription of beta-blocker and the patient's compliance with therapy. The three months survival without event (hospital readmission or death) did not significantly differ between the two groups: 45% [33-57] in 2000 versus 41% [29-53] in 2001.


CONCLUSIONS
The functional status and treatments of the patients significantly improved three months after their inclusion in health care network. The impact of the health care network for chronic heart failure management should be studied by randomised trials.
Fourny
M
M
Unité d'evaluation médicale, Pavillon Taillefer, CHU, BP 217, 38043 Grenoble 09, France. MFourny@chu-grenoble.fr
Neuder
Y
Y
Tranchant
L
L
François
P
P
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D016022:Case-Control Studies; D015331:Cohort Studies; D019033:Delivery of Health Care, Integrated; D004359:Drug Therapy, Combination; D005069:Evaluation Studies as Topic; D005260:Female; D005602:France; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D010349:Patient Compliance; D011446:Prospective Studies
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors