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.University of Groningen, Netherlands (author)

Long-term follow-up in optimally treated and stable heart failure patients: primary care vs. heart failure clinic. Results of the COACH-2 study

Article/chapterEnglish2014

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2014-10-10
Oxford University Press (OUP): Policy B / Wiley: 12 months,2014
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LIBRIS-ID:oai:DiVA.org:liu-112816
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-112816URI
https://doi.org/10.1002/ejhf.173DOI

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Language:English
Summary in:English

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SwePubSwePub

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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Funding Agencies|Netherlands Heart Foundation (NHF) [2008B083]
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 and genre

SAMHÄLLSVETENSKAP Sociologi hsv//swe
SOCIAL SCIENCES Sociology hsv//eng
Heart failure; Primary care; Disease management; Adherence

Added entries (persons, corporate bodies, meetings, titles ...)

Jaarsma, TinyLinköpings universitet,Hälsa, Aktivitet, Vård (HAV),Hälsouniversitetet(Swepub:liu)tinja77 (author)
van Geel, Peter PaulUniversity of Groningen, Netherlands (author)
Brons, MaaikeUniversity of Medical Centre Utrecht, Netherlands (author)
Hillege, Hans L.University of Groningen, Netherlands (author)
Hoes, Arno W.University of Medical Centre Utrecht, Netherlands (author)
de Jong, RichardWilhelmina Ziekenhuis Assen, Netherlands (author)
Linssen, GerardZiekenhuisgrp Twente, Netherlands; Ziekenhuisgrp Twente, Netherlands (author)
Lok, Dirk J. A.Stichting Deventer Ziekenhuizen, Netherlands (author)
Berge, MarjoleinUniversity of Groningen, Netherlands (author)
van Veldhuisen, Dirk J.University of Groningen, Netherlands (author)
University of Groningen, NetherlandsHälsa, Aktivitet, Vård (HAV) (creator_code:org_t)

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In:European Journal of Heart Failure: Oxford University Press (OUP): Policy B / Wiley: 12 months16:11, s. 1241-12481388-98421879-0844

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By the author/editor: Luttik, Marie Lo ...; Jaarsma, Tiny; van Geel, Peter ...; Brons, Maaike; Hillege, Hans L.; Hoes, Arno W.; show more...; de Jong, Richard; Linssen, Gerard; Lok, Dirk J. A.; Berge, Marjolein; van Veldhuisen, ...; show less...

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SOCIAL SCIENCES: SOCIAL SCIENCES; and Sociology

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By the university: Linköping University

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