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The benefits of using a heart failure management programme in Swedish primary healthcare
Author(s) -
Agvall Björn,
Alehagen Urban,
Dahlström Ulf
Publication year - 2013
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfs159
Subject(s) - medicine , heart failure , natriuretic peptide , intervention (counseling) , emergency department , quality of life (healthcare) , randomized controlled trial , clinical endpoint , emergency medicine , cardiac function curve , health care , intensive care medicine , nursing , economics , economic growth
Aim Heart failure (HF) is a common condition with which high mortality, morbidity, and poor quality of life are associated. It has previously been shown that use of HF management programmes (HFMPs) in HF clinics can be beneficial. The purpose of this study was to evaluate if the use of HFMPs also has beneficial effects on HF patients in primary healthcare (PHC). Methods and results This is a randomized, prospective, open‐label study including 160 patients from five PHC centres with systolic HF and a mean age of 75 years (standard deviation 7.8). In the intervention group, an intensive follow‐up was performed by HF nurses and physicians providing information and education about HF and the optimization of HF treatment according to recognized guidelines. There was a significant improvement of composite endpoints in the intervention group. Significantly more patients with reduced N‐terminal pro brain natriuretic peptide ( P = 0.012), improved cardiac function ( P = 0.03), fewer healthcare contacts ( P = 0.04), and fewer emergency room visits and admittances ( P = 0.0002 and P = 0.03, respectively) could be seen in the intervention group when compared with the control group. Conclusions The use of a HFMP in a PHC setting was found to have beneficial effects in terms of reducing the number of healthcare contacts and hospital admissions, and improving cardiac function in patients with systolic HF, even if the result should be interpreted with caution. It can therefore be recommended that HFMPs should be used in PHC.