RESICARD: East Paris network for the management of heart failure: absence of effect on mortality and rehospitalization in patients with severe heart failure admitted following severe decompensation.
BACKGROUND
Heart failure presents a major public health problem due to its high prevalence and the increasing number of hospital admissions for this condition. A coordinated healthcare network involving general practitioners and cardiologists was set up in the east of Paris in an effort to improve the management and outcomes of patients with severe heart failure.


OBJECTIVE
To reinforce patient education, improve compliance with medications and identify symptoms requiring treatment modification.


METHODS
In this 'before and after' study, the control group comprised patients hospitalized for severe heart failure who received conventional management in the year preceding the network set-up. The comparative group consisted of patients hospitalized for severe heart failure who underwent network-led care.


RESULTS
No significant differences were found between rates of first rehospitalization and all-cause mortality at 1 year between control and network groups, or between rates of first hospitalization due to cardiac causes, time to the first event, duration of hospitalization, rates of cardiac death or time to death.


CONCLUSIONS
In this non-randomized study, we found no benefit from management according to the RESICARD healthcare network in terms of mortality or hospitalization in patients with severe chronic heart failure.
Assyag
Patrick
P
IRDES, Paris, France.
Renaud
Thomas
T
Cohen-Solal
Alain
A
Viaud
Magali
M
Krys
Henry
H
Bundalo
Aleksandra
A
Michel
Pierre-Louis
PL
Boukobza
Robert
R
Bourgueil
Yann
Y
Cohen
Ariel
A
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000458:organization & administration*; D016507:Cardiology Service, Hospital / Q000458:organization & administration*; D002423:Cause of Death; D018572:Disease-Free Survival; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000401:mortality* / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010297:Paris; D010348:Patient Care Team / Q000458:organization & administration*; D010353:Patient Education as Topic; D010359:Patient Readmission; D015397:Program Evaluation; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome