January 31, 2020Journal of Cardiovascular Medicine
Structured telephone support programs in chronic heart failure may be affected by a learning curve
Key result
The HeartNetCare telephone support program did not significantly reduce all-cause death, heart failure hospitalization, or LVAD implantation compared to usual care (21.9% vs 24.5%; P=0.51).
Why the study?
The efficacy of telephone support programs in chronic heart failure has been questioned, especially in short-term follow-up, and the effect of a learning-to-care curve was unknown.
Does the HeartNetCare telephone support program improve outcomes in patients with chronic heart failure?
Population
269 chronic heart failure patients in HeartNetCare and 200 usual care controls
Comparison
HeartNetCare telephone support program vs usual care
Design
Retrospective cohort study
Follow-up
18 months
Authors
Discussion
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Member takes
Implication
HeartNetCare did not reduce hard endpoints in chronic HF; hypothesis-generating for surrogate benefits after learning curve.
Study Design
Type
Cohort (n=469)
Structured PICO
Does the HeartNetCare telephone support program improve outcomes in patients with chronic heart failure?
P
Population
469 patients with chronic heart failure, followed for 18 months to compare a structured telephone support program versus usual care.
E
Exposure
HeartNetCare telephone support program
C
Comparator
Usual care
O
Outcome
Composite of all-cause death, hospitalization for heart failure, or implantation of left ventricular assist devicecomposite
Main Result
Absolute Event Rate: 21.9% vs 24.5%
p-value: p=0.51
A structured telephone support program for chronic heart failure improved ejection fraction and NYHA class at 18 months, with potential benefits on clinical events emerging after an initial learning curve period.
Cite This Study
Tersalvi et al. (2020) conducted a cohort in chronic heart failure (n=469). HeartNetCare telephone support program vs. usual care was evaluated on All-cause death and hospitalization for heart failure or implantation of left ventricular assist device (p=0.51). The HeartNetCare telephone support program did not significantly reduce all-cause death, heart failure hospitalization, or LVAD implantation compared to usual care (21.9% vs 24.5%; P=0.51).