Multidisciplinary network in heart failure management in a community-based population: results and benefits at 2 years.
OBJECTIVE
To study the effects of a network using simple routine tools, in a community-based population.


METHODS
This is a non-randomized controlled study. Cardiosaintonge network set up on January 1st 2004, offered coordinating care involving general practitioners, cardiologists, nurses, physical therapists and dieticians to patients with heart failure.


RESULTS
After 2 years, 362 patients were included, 129 in the network and 233 in the usual care control group. The 2 groups were different for age but not for gender. The readmission rate was of 2.5 days per patient included in the network versus 4.8 in the control group. Twenty four patients (19%) died in the network and 82 (35%) in the control group (p=0.001). Survival analysis estimated a median survival time of >4 months (median survival not achieved within the follow-up) for the network group and 20 months for the non-network group (p=0.0004). The Cox model, adjusting on gender, age and NYHA stage determined the independent role of the network on longer survival since, the adjusted hazard ratio was of 0.37 for the network group (p=0.02). The Duke quality of life score marked a global improvement since admission, at months 6, 12, 18 and 24.


CONCLUSIONS
Cardiosaintonge network permits less readmissions and longer survival with better quality of life for patients with chronic heart failure.
Bonarek-Hessamfar
M
M
Benchimol
D
D
Lauribe
Ph
P
Hadjo
A
A
Matis
P
P
Dartigues
J F
JF
Bonnet
J
J
Benchimol
H
H
D000368:Aged; D000369:Aged, 80 and over; D019058:Community Networks / Q000458:organization & administration*; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team; D015397:Program Evaluation; D011446:Prospective Studies