Heart failure clinic in a community hospital improves outcome in heart failure patients.
BACKGROUND
Heart failure is associated with a grim prognosis. Disease management programmes can improve prognosis in heart failure patients but the applicability to the general population remains limited. We aimed to compare the outcome, pharmacological therapy, and quality of life in unselected heart failure patients from a community hospital area who were managed either in the heart failure clinic or who received the usual care.


RESULTS
We followed 115 patients receiving care in the heart failure clinic (n = 50) or the usual care (n = 65) for at least twelve months. During the follow-up of 561 (463, 701) days significantly less patients from the heart failure clinic were rehospitalized due to heart failure or died (42% vs 65%). Assignment to the heart failure clinic (Hazard ratio [HR] 0.39, 95% Confidence interval [CI] 0.20-0.75), New York Heart Association class (HR 2.32, 95% CI 1.22-4.41), and systolic blood pressure (HR 0.98, 95% CI 0.96-0.99) independently predicted occurrence of heart failure rehospitalisations or death. At the end of the follow-up patients from the heart failure clinic received more optimal pharmacological therapy and reported better quality of life.


CONCLUSIONS
Patient management in the community hospital heart failure clinic reduced the incidence of heart failure rehospitalisation or death with further benefits in terms of pharmacological therapy and quality of life.
Lainscak
Mitja
M
General Hospital Murska Sobota, Department of Internal Medcine, Slovenia. mitja.lainscak@guest.arnes.si
Keber
Irena
I
D000368:Aged; D000369:Aged, 80 and over; D016507:Cardiology Service, Hospital / Q000458:organization & administration* / Q000592:standards; D016022:Case-Control Studies; D018572:Disease-Free Survival; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006764:Hospitals, Community / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D011788:Quality of Life; D012189:Retrospective Studies; D017524:Slovenia; D016019:Survival Analysis