title: Open access to an outpatient intravenous diuresis program in a systolic heart failure disease management program.
abstract: In order to provide efficient utilization of resources in an outpatient setting for acute exacerbation of heart failure (HF), the authors piloted an open-access outpatient intravenous (IV) diuretic program (IVDP) to evaluate utilization in an HF disease management program (HFDMP), patient characteristics for users of the program, and safety. An outpatient HFDMP at Jackson Memorial Hospital in Miami, Florida, enrolling 577 patients 18 years and older with an ejection fraction ≤40% was implemented. For symptoms or weight gain ≥5 pounds, patients were eligible to use an open-access IVDP during clinic hours. A total of 130 HFDM patients (22.5%) used the IVDP. IVDP users were more likely to be diabetic, with lower body mass indices than non-IVDP users. New York Heart Association class IV patients and previously hospitalized patients were more likely to use the IVDP. There were no documented adverse reactions for patients receiving treatment and no difference in mortality between groups. This open-access outpatient IVDP model for patients with HF was readily utilized by the HFDMP participants and appears safe for use in this population. This unique model may provide alternative access for acute HF treatment. Congest Heart Fail.
authors: Division of Cardiology, the Department of Internal Medicine, Miller School of Medicine, University of Miami, FL, USA. khebert1@gmail.com
authors: Kathy
authors: K
authors: Hebert
authors: Andre
authors: A
authors: Dias
authors: Emiliana
authors: E
authors: Franco
authors: Leonardo
authors: L
authors: Tamariz
authors: Dylan
authors: D
authors: Steen
authors: Lee M
authors: LM
authors: Arcement
mesh_terms: D000553:Ambulatory Care / Q000379:methods*; D019468:Disease Management; D004232:Diuretics / Q000008:administration & dosage*; D005260:Female; D005431:Florida / Q000453:epidemiology; D005500:Follow-Up Studies; D054143:Heart Failure, Systolic / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010865:Pilot Projects; D015397:Program Evaluation / Q000706:statistics & numerical data*; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends
chemical_list: D004232:Diuretics