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Long-term follow-up...
Long-term follow-up in optimally treated and stable heart failure patients: primary care vs. heart failure clinic. Results of the COACH-2 study
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- Luttik, Marie Louise A. (author)
- University of Groningen, Netherlands
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- Jaarsma, Tiny (author)
- Linköpings universitet,Hälsa, Aktivitet, Vård (HAV),Hälsouniversitetet
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- van Geel, Peter Paul (author)
- University of Groningen, Netherlands
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- Brons, Maaike (author)
- University of Medical Centre Utrecht, Netherlands
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- Hillege, Hans L. (author)
- University of Groningen, Netherlands
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- Hoes, Arno W. (author)
- University of Medical Centre Utrecht, Netherlands
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- de Jong, Richard (author)
- Wilhelmina Ziekenhuis Assen, Netherlands
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- Linssen, Gerard (author)
- Ziekenhuisgrp Twente, Netherlands; Ziekenhuisgrp Twente, Netherlands
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- Lok, Dirk J. A. (author)
- Stichting Deventer Ziekenhuizen, Netherlands
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- Berge, Marjolein (author)
- University of Groningen, Netherlands
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- van Veldhuisen, Dirk J. (author)
- University of Groningen, Netherlands
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(creator_code:org_t)
- 2014-10-10
- 2014
- English.
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In: European Journal of Heart Failure. - : Oxford University Press (OUP): Policy B / Wiley: 12 months. - 1388-9842 .- 1879-0844. ; 16:11, s. 1241-1248
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Abstract
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- AimsIt has been suggested that home-based heart failure (HF) management in primary care may be an alternative to clinic-based management in HF patients. However, little is known about adherence to HF guidelines and adherence to the medication regimen in these home-based programmes. The aim of the current study was to determine whether long-term follow-up and treatment in primary care is equally effective as follow-up at a specialized HF clinic in terms of guideline adherence and patient adherence, in HF patients initially managed and up-titrated to optimal treatment at a specialized HF clinic. Methods and resultsWe conducted a multicentre, randomized, controlled study in 189 HF patients (62% male, age 72 11 years), who were assigned to follow-up either in primary care (n = 97) or in a HF clinic (n = 92). After 12 months, no differences between guideline adherence, as estimated by the Guideline Adherence Indicator (GAI-3), and patient adherence, in terms of the medication possession ratio (MPR), were found between treatment groups. There was no difference in the number of deaths (n = 12 in primary care and n = 8 in the HF clinic; P = 0.48), and hospital readmissions for cardiovascular (CV) reasons were also similar. The total number of unplanned non-CV hospital readmissions, however, tended to be higher in the primary care group (n = 22) than in the HF clinic group (n = 10; P = 0.05). Conclusionsless thanp id="ejhf173-para-0003"greater thanPatients discharged after initial management in a specialized HF clinic can be discharged to primary care for long-term follow-up with regard to maintaining guideline adherence and patient adherence. However, the complexity of the HF syndrome and its associated co-morbidities requires continuous monitoring. Close collaboration between healthcare providers will be crucial in order to provide HF patients with optimal, integrated care.
Subject headings
- SAMHÄLLSVETENSKAP -- Sociologi (hsv//swe)
- SOCIAL SCIENCES -- Sociology (hsv//eng)
Keyword
- Heart failure; Primary care; Disease management; Adherence
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Luttik, Marie Lo ...
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Jaarsma, Tiny
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van Geel, Peter ...
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Brons, Maaike
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Hillege, Hans L.
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Hoes, Arno W.
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de Jong, Richard
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Linssen, Gerard
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Lok, Dirk J. A.
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Berge, Marjolein
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van Veldhuisen, ...
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- About the subject
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- SOCIAL SCIENCES
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SOCIAL SCIENCES
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and Sociology
- Articles in the publication
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European Journal ...
- By the university
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Linköping University