PMID- 11595611
OWN - NLM
STAT- MEDLINE
DCOM- 20011205
LR  - 20191210
IS  - 1388-9842 (Print)
IS  - 1388-9842 (Linking)
VI  - 3
IP  - 5
DP  - 2001 Oct
TI  - Improved outcomes from a comprehensive management system for heart failure.
PG  - 619-25
AB  - AIMS: Congestive heart failure (CHF) is associated with a high readmission rate 
      after diagnosis. We assessed the ability of a comprehensive management program 
      (CMP) for CHF to reduce readmissions with secondary endpoints of improving 
      quality of life, exercise capacity and targeted drug doses. METHODS AND RESULTS: 
      Patients (pts) with: New York Heart Association Class (NYHA) III or IV CHF; left 
      ventricular ejection fraction <40%; and stable outpatient therapy were assigned 
      to a CMP of cardiology assessment intensive education and referral to a tailored 
      exercise program. Forty-two pts (35 M, 7 F, mean age 54 years, S.D. 12 years) 
      were enrolled. Two pts were transplanted, two died during follow-up and two were 
      lost to follow-up. Hospital admissions were reduced by 87.2%, (mean 1.05, S.D. 
      0.98, admissions per pt to mean 0.08, S.D. 0.28, admissions per pt at 6-month 
      follow-up; P<0.0001). ACE-inhibitor dose increased by 42% (P<0.0008) and 
      beta-blocker dose increased by 61% (P<0.0001). NYHA Class, 6-min walk and quality 
      of life scores all improved significantly (P<0.0001). CONCLUSION: A CMP improves 
      QOL and exercise capacity as well as substantially reducing hospital admissions 
      in CHF pts. This study validates the benefit of intensive outpatient care of CHF.
FAU - Holst, D P
AU  - Holst DP
AD  - Cardiovascular Medicine, Heart Centre, Alfred Hospital, Commercial Road, Prahran, 
      Melbourne, Victoria 3181, Australia. d.holst@alfred.org.au
FAU - Kaye, D
AU  - Kaye D
FAU - Richardson, M
AU  - Richardson M
FAU - Krum, H
AU  - Krum H
FAU - Prior, D
AU  - Prior D
FAU - Aggarwal, A
AU  - Aggarwal A
FAU - Wolfe, R
AU  - Wolfe R
FAU - Bergin, P
AU  - Bergin P
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Eur J Heart Fail
JT  - European journal of heart failure
JID - 100887595
SB  - IM
MH  - Aged
MH  - Chronic Disease
MH  - *Disease Management
MH  - Female
MH  - Heart Failure/*rehabilitation/therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment, Health Care/*methods/organization & administration
MH  - Patient Readmission/statistics & numerical data
MH  - Program Evaluation
MH  - Prospective Studies
MH  - Quality of Life
MH  - Severity of Illness Index
EDAT- 2001/10/12 10:00
MHDA- 2002/01/05 10:01
CRDT- 2001/10/12 10:00
PHST- 2001/10/12 10:00 [pubmed]
PHST- 2002/01/05 10:01 [medline]
PHST- 2001/10/12 10:00 [entrez]
AID - S1388-9842(01)00164-7 [pii]
AID - 10.1016/s1388-9842(01)00164-7 [doi]
PST - ppublish
SO  - Eur J Heart Fail. 2001 Oct;3(5):619-25. doi: 10.1016/s1388-9842(01)00164-7.