PMID- 11264552
OWN - NLM
STAT- MEDLINE
DCOM- 20010521
LR  - 20191210
IS  - 1071-9164 (Print)
IS  - 1071-9164 (Linking)
VI  - 7
IP  - 1
DP  - 2001 Mar
TI  - Prospective evaluation of an outpatient heart failure management program.
PG  - 64-74
AB  - BACKGROUND: Although considerable effort has been devoted to the follow-up of 
      hospitalized patients, the effectiveness and process of heart failure outpatient 
      management have not been well demonstrated. METHODS AND RESULTS: All new patients 
      referred to the program from April 1997 to September 1998 were followed and 
      managed by comprehensive strategies including preemptive hospitalization. Quality 
      of life (QOL) and patients' self-care adherence behaviors were measured at 
      baseline, 3 months, and 6 months. Clinical outcomes were compared for the 6 
      months before and 6 months after referral. A total of 108 patients were 
      recruited. Patients' self-care knowledge score was improved over time (difference 
      score = 0.9, P <.01). The proportion of patients weighing themselves daily 
      increased by 24% (P =.02). The proportion of patients with New York Heart 
      Association (NYHA) class III to IV was 67.6% at baseline and 49.1% at 6 months (P 
      =.01). Compared with 6 months before referral, the program intervention was 
      accompanied by a 52% reduction in the risk of hospitalization for cardiovascular 
      causes (56.1% v 27.2%, P <.001) and a 72% reduction in emergency room visits 
      (53.6% v 14.5%, P <.01). The total hospital admissions for cardiovascular causes 
      decreased by 59% from 94 to 39; the total emergency room visits decreased by 77% 
      from 83 to 19. The patients' QOL was improved over time with a change score of 
      11.2 (P <.001) at 3 months and 10.7 (P <.001) at 6 months. CONCLUSION: Our study 
      shows the effectiveness of this heart failure outpatient management program.
FAU - Hershberger, R E
AU  - Hershberger RE
AD  - Oregon Heart Failure Project, Heart Failure Treatment Program, Oregon Health 
      Sciences University, Portland, Oregon 97201-3098, USA.
FAU - Ni, H
AU  - Ni H
FAU - Nauman, D J
AU  - Nauman DJ
FAU - Burgess, D
AU  - Burgess D
FAU - Toy, W
AU  - Toy W
FAU - Wise, K
AU  - Wise K
FAU - Dutton, D
AU  - Dutton D
FAU - Crispell, K
AU  - Crispell K
FAU - Vossler, M
AU  - Vossler M
FAU - Everett, J
AU  - Everett J
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
SB  - IM
MH  - Adult
MH  - Costs and Cost Analysis
MH  - Disease Management
MH  - Evaluation Studies as Topic
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/physiopathology/*psychology/*therapy
MH  - Heart Ventricles/diagnostic imaging
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment, Health Care
MH  - Outpatients
MH  - Patient Compliance/psychology
MH  - Prospective Studies
MH  - Quality of Life/psychology
MH  - Radionuclide Imaging
MH  - Self Care/economics/psychology
MH  - Time Factors
EDAT- 2001/03/27 10:00
MHDA- 2001/05/25 10:01
CRDT- 2001/03/27 10:00
PHST- 2001/03/27 10:00 [pubmed]
PHST- 2001/05/25 10:01 [medline]
PHST- 2001/03/27 10:00 [entrez]
AID - S1071-9164(01)79713-8 [pii]
AID - 10.1054/jcaf.2001.21677 [doi]
PST - ppublish
SO  - J Card Fail. 2001 Mar;7(1):64-74. doi: 10.1054/jcaf.2001.21677.