What question did this study set out to answer?

To evaluate the clinical and economic impact of implementing a specialized disease management program for congestive heart failure at a tertiary care center.

October 8, 2001Archives of Internal Medicine

The Benefit of Implementing a Heart Failure Disease Management Program

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Why the study?

Does a CHF disease management program improve beta-blocker use and reduce healthcare costs in patients with severe heart failure?

Population

117 patients with congestive heart failure at a tertiary care center.

Comparison

CHF disease management program vs Preenrollment period

Design

Cohort

Follow-up

mean 4.7 months

Authors

DWDavid J. WhellanHeart Failure & Transplant LGLaura GauldenMACOM (United States)WGWendy A. GattisBoston University

Discussion

Member takes

Implication

Supports consideration of HF disease management programs; leaves open whether randomized trials confirm reduced hospitalizations.

Key Points

To evaluate the clinical and economic impact of implementing a specialized disease management program for congestive heart failure at a tertiary care center.
Enrolled 117 patients with congestive heart failure between July 1998 and April 1999, with a mean follow-up duration of 4.7 months.
Eligible patients had a recent heart failure hospitalization, left ventricular ejection fraction less than 20%, or NYHA class III or IV symptoms.
Compared pre-enrollment and post-enrollment medication use, clinic visits, hospitalizations, and healthcare costs.
Beta-blocker prescription rates increased from 52% to 76% (P < .01), and the proportion achieving target doses increased from 6% to 13% (P < .01).
Hospitalizations fell from 1.5 to 0 per patient-year (P < .01), while outpatient clinic visits rose from 4.3 to 9.8 per patient-year (P < .01).
Implementation of the management program yielded a median healthcare cost savings of $8,571 per patient-year.

Structured PICO

Does a CHF disease management program improve beta-blocker use and reduce healthcare costs in patients with severe heart failure?

Population

117 patients with congestive heart failure (recent CHF hospitalization, ejection fraction <20%, or NYHA class III/IV) at a tertiary care center.

Intervention

CHF disease management program (Duke Heart Failure Program)

Comparator

Preenrollment period (patients served as their own controls)

Outcome

Beta-blocker use and cost to the health care system (including hospitalization rate and clinic visits)

Implementing a heart failure disease management program significantly improves guideline-directed medical therapy utilization and reduces hospitalizations and healthcare costs.

Cite This Study

Whellan et al. (2001) studied this question.

synapsesocial.com/papers/6a70460f35aa2c282ce19279 https://doi.org/10.1001/archinte.161.18.2223

Topics

Heart failure HFrEF treatment HFpEF management Heart failure hospitalization

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The Benefit of Implementing a Heart Failure Disease Management Program

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

The Benefit of Implementing a Heart Failure Disease Management Program

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider