A multicenter disease management program for hospitalized patients with heart failure
Despite the availability of proven therapies, outcomes in patients with heart failure (HF) remain poor. In this 2-stage, multicenter trial, we evaluated the effect of a disease management program on clinical and economic outcomes in patients with HF. In Stage 1, a pharmacist or nurse assessed each p...
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| Veröffentlicht in: | Journal of cardiac failure 2004-12, Vol.10 (6), p.473-480 |
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| creator | Tsuyuki, Ross T. Fradette, Miriam Johnson, Jeffrey A. Bungard, Tammy J. Eurich, Dean T. Ashton, Thomas Gordon, Wendy Ikuta, Roland Kornder, Jan Mackay, Elizabeth Manyari, Dante O’Reilly, Ken Semchuk, William for the react investigators |
| description | Despite the availability of proven therapies, outcomes in patients with heart failure (HF) remain poor. In this 2-stage, multicenter trial, we evaluated the effect of a disease management program on clinical and economic outcomes in patients with HF.
In Stage 1, a pharmacist or nurse assessed each patient and made recommendations to the physician to add or adjust angiotensin-converting enzyme (ACE) inhibitors and other HF medications. Before discharge (Stage 2), patients were randomized to a patient support program (PSP) (education about HF, self-monitoring, adherence aids, newsletters, telephone hotline, and follow-up at 2 weeks, then monthly for 6 months after discharge) or usual care. In Stage 1 (766 patients) ACE inhibitor use increased from 58% on admission to 83% at discharge (
P < .0001), and the daily dose (in enalapril equivalents) increased from 11.3±8.8 mg to 14.5±8.8 mg (
P < .0001). In Stage 2 (276 patients) there was no difference in ACE inhibitor adherence, but a reduction in cardiovascular-related emergency room visits (49 versus 20,
P
=
.030), hospitalization days (812 versus 341,
P
=
.003), and cost of care ($CDN 2,531 less per patient) in favor of the PSP.
Simple interventions can improve ACE inhibitor use and patient outcomes. |
| doi_str_mv | 10.1016/j.cardfail.2004.02.005 |
| format | Article |
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In Stage 1, a pharmacist or nurse assessed each patient and made recommendations to the physician to add or adjust angiotensin-converting enzyme (ACE) inhibitors and other HF medications. Before discharge (Stage 2), patients were randomized to a patient support program (PSP) (education about HF, self-monitoring, adherence aids, newsletters, telephone hotline, and follow-up at 2 weeks, then monthly for 6 months after discharge) or usual care. In Stage 1 (766 patients) ACE inhibitor use increased from 58% on admission to 83% at discharge (
P < .0001), and the daily dose (in enalapril equivalents) increased from 11.3±8.8 mg to 14.5±8.8 mg (
P < .0001). In Stage 2 (276 patients) there was no difference in ACE inhibitor adherence, but a reduction in cardiovascular-related emergency room visits (49 versus 20,
P
=
.030), hospitalization days (812 versus 341,
P
=
.003), and cost of care ($CDN 2,531 less per patient) in favor of the PSP.
Simple interventions can improve ACE inhibitor use and patient outcomes.</description><identifier>ISSN: 1071-9164</identifier><identifier>EISSN: 1532-8414</identifier><identifier>DOI: 10.1016/j.cardfail.2004.02.005</identifier><identifier>PMID: 15599837</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>ACE inhibitors ; Aged ; Aged, 80 and over ; Angiotensin-Converting Enzyme Inhibitors - therapeutic use ; Canada ; Congestive heart failure ; Counseling ; Disease Management ; Female ; health care economics ; Heart Failure - drug therapy ; Heart Failure - therapy ; Hospitalization - economics ; Humans ; Inpatients - education ; Inpatients - psychology ; Male ; Middle Aged ; Patient Care Team ; Patient Compliance ; Patient Education as Topic</subject><ispartof>Journal of cardiac failure, 2004-12, Vol.10 (6), p.473-480</ispartof><rights>2004 Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c366t-3b16a49ebed6f4415061b42a8694212bf572cfd30c5ed9aae4f6810493c1b3093</citedby><cites>FETCH-LOGICAL-c366t-3b16a49ebed6f4415061b42a8694212bf572cfd30c5ed9aae4f6810493c1b3093</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.cardfail.2004.02.005$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15599837$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tsuyuki, Ross T.</creatorcontrib><creatorcontrib>Fradette, Miriam</creatorcontrib><creatorcontrib>Johnson, Jeffrey A.</creatorcontrib><creatorcontrib>Bungard, Tammy J.</creatorcontrib><creatorcontrib>Eurich, Dean T.</creatorcontrib><creatorcontrib>Ashton, Thomas</creatorcontrib><creatorcontrib>Gordon, Wendy</creatorcontrib><creatorcontrib>Ikuta, Roland</creatorcontrib><creatorcontrib>Kornder, Jan</creatorcontrib><creatorcontrib>Mackay, Elizabeth</creatorcontrib><creatorcontrib>Manyari, Dante</creatorcontrib><creatorcontrib>O’Reilly, Ken</creatorcontrib><creatorcontrib>Semchuk, William</creatorcontrib><creatorcontrib>for the react investigators</creatorcontrib><title>A multicenter disease management program for hospitalized patients with heart failure</title><title>Journal of cardiac failure</title><addtitle>J Card Fail</addtitle><description>Despite the availability of proven therapies, outcomes in patients with heart failure (HF) remain poor. In this 2-stage, multicenter trial, we evaluated the effect of a disease management program on clinical and economic outcomes in patients with HF.
In Stage 1, a pharmacist or nurse assessed each patient and made recommendations to the physician to add or adjust angiotensin-converting enzyme (ACE) inhibitors and other HF medications. Before discharge (Stage 2), patients were randomized to a patient support program (PSP) (education about HF, self-monitoring, adherence aids, newsletters, telephone hotline, and follow-up at 2 weeks, then monthly for 6 months after discharge) or usual care. In Stage 1 (766 patients) ACE inhibitor use increased from 58% on admission to 83% at discharge (
P < .0001), and the daily dose (in enalapril equivalents) increased from 11.3±8.8 mg to 14.5±8.8 mg (
P < .0001). In Stage 2 (276 patients) there was no difference in ACE inhibitor adherence, but a reduction in cardiovascular-related emergency room visits (49 versus 20,
P
=
.030), hospitalization days (812 versus 341,
P
=
.003), and cost of care ($CDN 2,531 less per patient) in favor of the PSP.
Simple interventions can improve ACE inhibitor use and patient outcomes.</description><subject>ACE inhibitors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</subject><subject>Canada</subject><subject>Congestive heart failure</subject><subject>Counseling</subject><subject>Disease Management</subject><subject>Female</subject><subject>health care economics</subject><subject>Heart Failure - drug therapy</subject><subject>Heart Failure - therapy</subject><subject>Hospitalization - economics</subject><subject>Humans</subject><subject>Inpatients - education</subject><subject>Inpatients - psychology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patient Care Team</subject><subject>Patient Compliance</subject><subject>Patient Education as Topic</subject><issn>1071-9164</issn><issn>1532-8414</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkDtv2zAQgImiQZM4-QsBp25SjhRFiVsNo3kAAbLEM0GRJ5uGZLkk1aL59aFhFx0z3eHw3esj5I5ByYDJ-11pTXC98UPJAUQJvASov5ArVle8aAUTX3MODSsUk-KSXMe4A4BWQPONXLK6VqqtmiuyXtJxHpK3uE8YqPMRTUQ6mr3Z4JiL9BCmTTAj7adAt1M8-GQG_46OHkzyGYj0j09bukUTEj0eNAe8IRe9GSLenuOCrB9-vq2eipfXx-fV8qWwlZSpqDomjVDYoZO9EKwGyTrBTSuV4Ix3fd1w27sKbI1OGYOily0DoSrLugpUtSDfT3Pzkb9mjEmPPlocBrPHaY5aNqzhqhYZlCfQhinGgL0-BD-a8Fcz0Eeheqf_CdVHoRq4zkJz4915w9yN6P63nQ1m4McJwPznb49BR5u1WHQ-oE3aTf6zHR-6doth</recordid><startdate>20041201</startdate><enddate>20041201</enddate><creator>Tsuyuki, Ross T.</creator><creator>Fradette, Miriam</creator><creator>Johnson, Jeffrey A.</creator><creator>Bungard, Tammy J.</creator><creator>Eurich, Dean T.</creator><creator>Ashton, Thomas</creator><creator>Gordon, Wendy</creator><creator>Ikuta, Roland</creator><creator>Kornder, Jan</creator><creator>Mackay, Elizabeth</creator><creator>Manyari, Dante</creator><creator>O’Reilly, Ken</creator><creator>Semchuk, William</creator><creator>for the react investigators</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20041201</creationdate><title>A multicenter disease management program for hospitalized patients with heart failure</title><author>Tsuyuki, Ross T. ; Fradette, Miriam ; Johnson, Jeffrey A. ; Bungard, Tammy J. ; Eurich, Dean T. ; Ashton, Thomas ; Gordon, Wendy ; Ikuta, Roland ; Kornder, Jan ; Mackay, Elizabeth ; Manyari, Dante ; O’Reilly, Ken ; Semchuk, William ; for the react investigators</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c366t-3b16a49ebed6f4415061b42a8694212bf572cfd30c5ed9aae4f6810493c1b3093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>ACE inhibitors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</topic><topic>Canada</topic><topic>Congestive heart failure</topic><topic>Counseling</topic><topic>Disease Management</topic><topic>Female</topic><topic>health care economics</topic><topic>Heart Failure - drug therapy</topic><topic>Heart Failure - therapy</topic><topic>Hospitalization - economics</topic><topic>Humans</topic><topic>Inpatients - education</topic><topic>Inpatients - psychology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patient Care Team</topic><topic>Patient Compliance</topic><topic>Patient Education as Topic</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tsuyuki, Ross T.</creatorcontrib><creatorcontrib>Fradette, Miriam</creatorcontrib><creatorcontrib>Johnson, Jeffrey A.</creatorcontrib><creatorcontrib>Bungard, Tammy J.</creatorcontrib><creatorcontrib>Eurich, Dean T.</creatorcontrib><creatorcontrib>Ashton, Thomas</creatorcontrib><creatorcontrib>Gordon, Wendy</creatorcontrib><creatorcontrib>Ikuta, Roland</creatorcontrib><creatorcontrib>Kornder, Jan</creatorcontrib><creatorcontrib>Mackay, Elizabeth</creatorcontrib><creatorcontrib>Manyari, Dante</creatorcontrib><creatorcontrib>O’Reilly, Ken</creatorcontrib><creatorcontrib>Semchuk, William</creatorcontrib><creatorcontrib>for the react investigators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiac failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tsuyuki, Ross T.</au><au>Fradette, Miriam</au><au>Johnson, Jeffrey A.</au><au>Bungard, Tammy J.</au><au>Eurich, Dean T.</au><au>Ashton, Thomas</au><au>Gordon, Wendy</au><au>Ikuta, Roland</au><au>Kornder, Jan</au><au>Mackay, Elizabeth</au><au>Manyari, Dante</au><au>O’Reilly, Ken</au><au>Semchuk, William</au><au>for the react investigators</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A multicenter disease management program for hospitalized patients with heart failure</atitle><jtitle>Journal of cardiac failure</jtitle><addtitle>J Card Fail</addtitle><date>2004-12-01</date><risdate>2004</risdate><volume>10</volume><issue>6</issue><spage>473</spage><epage>480</epage><pages>473-480</pages><issn>1071-9164</issn><eissn>1532-8414</eissn><abstract>Despite the availability of proven therapies, outcomes in patients with heart failure (HF) remain poor. In this 2-stage, multicenter trial, we evaluated the effect of a disease management program on clinical and economic outcomes in patients with HF.
In Stage 1, a pharmacist or nurse assessed each patient and made recommendations to the physician to add or adjust angiotensin-converting enzyme (ACE) inhibitors and other HF medications. Before discharge (Stage 2), patients were randomized to a patient support program (PSP) (education about HF, self-monitoring, adherence aids, newsletters, telephone hotline, and follow-up at 2 weeks, then monthly for 6 months after discharge) or usual care. In Stage 1 (766 patients) ACE inhibitor use increased from 58% on admission to 83% at discharge (
P < .0001), and the daily dose (in enalapril equivalents) increased from 11.3±8.8 mg to 14.5±8.8 mg (
P < .0001). In Stage 2 (276 patients) there was no difference in ACE inhibitor adherence, but a reduction in cardiovascular-related emergency room visits (49 versus 20,
P
=
.030), hospitalization days (812 versus 341,
P
=
.003), and cost of care ($CDN 2,531 less per patient) in favor of the PSP.
Simple interventions can improve ACE inhibitor use and patient outcomes.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>15599837</pmid><doi>10.1016/j.cardfail.2004.02.005</doi><tpages>8</tpages></addata></record> |
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| ispartof | Journal of cardiac failure, 2004-12, Vol.10 (6), p.473-480 |
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| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | ACE inhibitors Aged Aged, 80 and over Angiotensin-Converting Enzyme Inhibitors - therapeutic use Canada Congestive heart failure Counseling Disease Management Female health care economics Heart Failure - drug therapy Heart Failure - therapy Hospitalization - economics Humans Inpatients - education Inpatients - psychology Male Middle Aged Patient Care Team Patient Compliance Patient Education as Topic |
| title | A multicenter disease management program for hospitalized patients with heart failure |
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