Effects of integrated disease management program on the outcome of patients with heart failure
10.3760/cma.j.issn.0253-3758.2010.07.005
- VernacularTitle:三级医院心力衰竭门诊管理方案对患者预后的影响
- Author:
Hui-Hua FAN
1
;
Hao-Ying SHI
;
Wei JIN
;
Ya-Juan ZHU
;
Dai-Ni HUANG
;
Yi-Wen YAN
;
Feng ZHU
;
Hong-Li LI
;
Jian LIU
;
Shao-Wen LIU
Author Information
1. 上海交通大学医学院附属第一人民医院
- Keywords:
Heart failure,congestive;
Disease management;
Prognosis;
Quality of life
- From:
Chinese Journal of Cardiology
2010;38(7):592-596
- CountryChina
- Language:Chinese
-
Abstract:
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 (re = 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 ). Conclusion 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.
