May 30, 2018BMC Health Services ResearchOpen Access

Opposite trends in hospitalization and mortality after implementation of a chronic care model-based regional program for the management of patients with heart failure in primary care

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Why the study?

Does a chronic care model-based regional program reduce heart failure hospitalization and all-cause mortality in patients with chronic heart failure in primary care?

Population

5,283 patients with chronic heart failure in primary care, based in Tuscany, Italy.

Comparison

Primary-care, chronic care model-based project… vs Usual care by general practitioners not involved…

Design

Cohort

Follow-up

4 years

Authors

PBPiercarlo BalloOspedale Santa Maria Annunziata FPFrancesco ProfiliAgenzia Regionale di Sanità della Toscana LPLaura PolicardoMinistry of Agricultural, Food and Forestry Policies

Discussion

Member takes

Implication

CCM associated with lower mortality but more HF hospitalizations in primary care; hypothesis-generating and should not yet change practice pending RCTs.

Structured PICO

Does a chronic care model-based regional program reduce heart failure hospitalization and all-cause mortality in patients with chronic heart failure in primary care?

Population

5,283 patients with chronic heart failure in primary care (n=1,761 in intervention cohort, n=3,522 matched controls), based in Tuscany, Italy.

Intervention

Primary-care, chronic care model (CCM)-based project including predefined working teams (general practitioners and nurses), proactively scheduled regular follow-up visitations, counseling for therapy adherence and lifestyle modifications, and appropriate diagnostic and therapeutic pathways.

Comparator

Usual care by general practitioners not involved in the CCM project.

Outcome

Heart failure hospitalization and all-cause mortality over a 4-year follow-up period.hard clinical

Implementation of a chronic care model for heart failure in primary care was associated with reduced mortality but increased heart failure hospitalizations, largely driven by planned admissions.

Cite This Study

Ballo et al. (2018) studied this question.

synapsesocial.com/papers/6a87efd3010a27dee476e6db https://doi.org/10.1186/s12913-018-3164-0

Topics

Heart failure HFrEF treatment Heart failure hospitalization HFpEF management

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Implication

CCM associated with lower mortality but more HF hospitalizations in primary care; hypothesis-generating and should not yet change practice pending RCTs.

Opposite trends in hospitalization and mortality after implementation of a chronic care model-based regional program for the management of patients with heart failure in primary care

Discussion

Member takes

Implication

Structured PICO

Cite This Study

Topics

Opposite trends in hospitalization and mortality after implementation of a chronic care model-based regional program for the management of patients with heart failure in primary care

Discussion

Member takes

Implication

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider