[Effects of integrated disease management program on the outcome of patients with heart failure].
OBJECTIVE
To investigate the feasibility and efficacy on the outcome of patients with heart failure of integrated disease management program with heart failure clinic, patient education and telephone follow-up.


METHODS
A total of 145 hospitalized patients with chronic heart failure and LVEF ≤ 45% or patients with LVEF > 45% and NT-proBNP > 1500 ng/L were divided into conventional group (n = 71) and interventional group (n = 74). Patients were followed for 10 to 12 months.


RESULTS
Baseline clinical characteristics, LVEF and dose of evidence-based medicine were similar between the 2 groups. During follow-up, the NYHA functional class was higher in conventional group than interventional group (3.2 ± 0.5 vs 1.4 ± 0.5, P < 0.05), and the LVEF deteriorated in the conventional group and improved from 34% to 40%in the interventional group. The proportions of self-monitoring of weight, blood pressure and pulse rate in the interventional group were significantly higher than those of conventional group (P < 0.05). Among patients with systolic heart failure, 40% patients in the interventional group and 11% patients in the conventional group achieved the target doses of β-blockers (P < 0.05). Cardiovascular event rate of conventional group and interventional group is 91.5% and 27.0% respectively (P < 0.05).


CONCLUSIONS
Integrated disease management program with heart failure clinic, patient education and telephone follow-up can improve patient compliance to heart failure treatment, improve cardiac function and reduce cardiovascular event rate.
Department of Cardiology, Shanghai First People's Hospital, Shanghai Jiaotong University, Shanghai 200080, China.
Hui-hua
HH
Fan
Hao-ying
HY
Shi
Wei
W
Jin
Ya-juan
YJ
Zhu
Dai-ni
DN
Huang
Yi-wen
YW
Yan
Feng
F
Zhu
Hong-li
HL
Li
Jian
J
Liu
Shao-wen
SW
Liu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D019468:Disease Management; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011379:Prognosis; D011788:Quality of Life; D016896:Treatment Outcome