To analyze the effect of introduction of post-discharge follow-up phone calls and weekly educational group sessions policy for heart failure patients by Hahnemann University Hospital on its 30-day re-hospitalization rates for these patients

2021 ◽  
Author(s):  
Dheeraj Goyal
Keyword(s):  
Heart Failure ◽  
University Hospital ◽  
Post Discharge ◽  
Heart Failure Patients ◽  
Educational Group ◽  
Phone Calls ◽  
Hospitalization Rates ◽  
Group Sessions

scholarly journals Applicability of structured telephone monitoring to follow up heart failure patients discharged from Muhimbili National Hospital, Tanzania

2017 ◽  
Vol 19 (2) ◽  
Author(s):  
Sabina Mmbali ◽  
Pilly Chillo
Keyword(s):  
Heart Failure ◽  
Mobile Phones ◽  
Clinical Status ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Post Discharge ◽  
Heart Failure Patients ◽  
Resource Poor ◽  
Telephone Monitoring

Background: Studies from developed countries have shown that home monitoring and follow up of heart failure (HF) patients by use of phone calls is cost-effective as it reduces re-admission and improves patients’ clinical status. This intervention has however not been tested in resource poor countries including Tanzania, and there are questions as to whether it is applicable in such situations. This study was carried out to determine the applicability of structured telephone monitoring of HF patients discharged from Muhimbili National Hospital in Dar es Salaam, Tanzania.   Methods: All heart failure patients admitted at the hospital’s Cardiovascular Medicine Department between August and December 2014 were consecutively recruited. Information on their clinical and demographic characteristics was collected and their mobile phone numbers recorded. Patients were then contacted through their phones on day 7, 14 and 30 post discharge and inquiry on their clinical status was made.Results: A total of 164 HF patients were admitted during the study period, of these 4 declined to participate, 3 could not establish a phone number and 26 died before discharge leaving 131 (79.9%) for follow-up. The mean age was 45±19 years and 56.5% were women. The proportion of patients that could be contacted through mobile phones were 96.2%, 94.7% and 93.9% on day 7, 14 and 30 post discharge, respectively. Over 90% of the contacted patients gave valuable information regarding their clinical status.Conclusion: Majority of HF patients can be contacted and provide valuable clinical information through mobile phones within a month post discharge from the national hospital in Tanzania.  Structured telephone monitoring could be used as a tool to follow up HF patients in a resource-poor country like Tanzania.

EFFICACY OF CARDIAC RESYNCHRONIZATION THERAPY IN HEART FAILURE AT HUE UNIVERSITY HOSPITAL

2012 ◽  
pp. 37-43
Author(s):  
Anh Tien Hoang ◽  
Anh Tuan Ho ◽  
Van Minh Huynh ◽  
Van Dien Nguyen
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Nyha Class ◽  
Pacemaker Implantation ◽  
University Hospital ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Heart Failure Patients ◽  
Ventricular Dyssynchrony

Background: Cardiac resynchronization therapy is one of new methods used to treating patients with heart failure who have ventricular dyssynchrony. Objectives: 1. To study clinical, laboratory characteristis of heart failure patients with ventricular dyssynchrony. 2. To study the efficacy of cardiac resynchronization therapy in treating such group of patients. Materials and method: From February 2009 to February 2011, we implanted biventricular pacemakers at Hue University Hospital for 15 patients who had NYHA class III and IV heart failure and had been treated with optimal medical therapy, LVEF ≤35%, QRS duration ≥ 120ms. Result: 14/15 cases succeeded, cardiac function improved after 1 year follow – up of biventricular pacemaker implantation, with significantly increased EF, decreased LVIDd, PAPs. At the cut off of EF <30%, the rate of patients with EF <30% declined chronologically (1 year of follow – up). Functional symptoms improved overtly according to NYHA class. The choice of A-V delay and V-V delay is very important. Optimal A-V delay and V-V delay after programming were (152±8.33)ms and (26.33±6.31)ms, retrospectively. Conclusion: Cardiac resynchronization therapy is effective in improving heart failure patients with ventricular dyssynchronization.

Long-term Clinical Follow-up of Japanese Heart Failure Patients Received ICD Therapy for Primary Prevention of Sudden Cardiac Death

2008 ◽  
Vol 14 (7) ◽  
pp. S140-S141
Author(s):  
Kenji Ando ◽  
Yoshimitsu Soga ◽  
Masahiko Goya ◽  
Shinichi Shirai ◽  
Shinya Nagayama ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Prevention ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Icd Therapy ◽  
Heart Failure Patients

Twin peaks diversity with sacubitril/valsartan treatment responses in cardiomyopathic heart failure patients of non-ischemic compared to ischemic etiologies

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H.Y Chang ◽  
W.R Chiou ◽  
P.L Lin ◽  
C.Y Hsu ◽  
C.T Liao ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Endpoint ◽  
Ischemic Cardiomyopathy ◽  
Ventricular Remodeling ◽  
Left Ventricular Ejection ◽  
Funding Source ◽  
Heart Failure Patients ◽  
Twin Peaks ◽  
All Cause Mortality

Abstract Background Ischemic cardiomyopathy (ICM) has been associated with increased mortality when compared with non-ischemic cardiomyopathy (NICM) from several heart failure (HF) cohorts. Instead, PARADIGM study demonstrated similar event rates of cardiovascular (CV) death, all-cause mortality and HF readmissions between ICM and NICM patients. Although the beneficiary effect of sacubitril/valsartan (SAC/VAL) compared to enalapril on these endpoints was consistent across etiologic categories, PARADIGM study did not analyze the effect of ventricular remodeling of SAC/VAL on patients with different HF etiologies, which may significantly affect treatment outcomes. Purpose We aim to compare alterations of left ventricular ejection fraction (LVEF) following SAC/VAL treatment and its association with clinical outcomes in patients with different HF etiologies. Methods Treatment with angiotensin receptor neprilysin inhibitor for Taiwan heart failure patients (TAROT-HF) study is a multicenter study which enrolled 1552 patients with LVEF &lt;40%, whom had been on SAC/VAL treatment from 9 hospitals between 2017 and 2018. After excluding patients without having follow-up echocardiographic studies, patients were grouped by HF etiologies and by LVEF changes following treatment for 8-month period. LVEF improvement ≥15% was defined as “significant improvement”, 5–15% as “marginal improvement”, and &lt;5% or worse as “lack of improvement”. The primary endpoint was a composite of CV death or a first hospitalization for HF. Mean follow-up period was 726 days. Results A total of 1230 patients were analyzed. Patients with ICM were significantly older, more male, and prone to have associated hypertension and diabetes. On the other hand, patients with NICM had lower LVEF and higher likelihood of atrial fibrillation. LVEF increase was significantly greater in patients with NICM compared to those with ICM (11.2±12.4% vs. 6.9±9.8, p&lt;0.001). The effect of ventricular remodeling of SAC/VAL on patients with NICM showed twin peaks diversity (Significant improvement 37.1%, lack of improvement 42.3%), whereas in patients with ICM the proportions of significant, marginal and lack of improvement groups were 19.4%, 28.2% and 52.4%, respectively. The primary endpoint showed twin peaks diversity also in patients with NICM in line with LVEF changes: adjusted HR for patients with NICM and significant improvement was 0.41 (95% CI 0.29–0.57, p&lt;0.001), for patients with NICM and lack of improvement was 1.54 (95% CI 1.22–1.94, p&lt;0.001). Analyses for CV death, all-cause mortality, and HF readmission demonstrated consistent results. Conclusion Patients with NICM had higher degree of LVEF improvement than those with ICM following SAC/VAL treatment, and significant improvement of LVEF in NICM patients may indicate favorable outcome. NICM patients without response to SAC/VAL treatment should serve as an indicator for poor clinical outcome and warranted meticulous HF management. Funding Acknowledgement Type of funding source: Private hospital(s). Main funding source(s): Cheng Hsin General Hospital

scholarly journals Left ventricular systolic function decreases in lamin a/c cardiomyopathy wihout concomitant ventricular dilatation

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
ES Eystein Skjolsvik ◽  
OL Oyvind Haugen Lie ◽  
MC Monica Chivulescu ◽  
MR Margareth Ribe ◽  
AIC Anna Isotta Castrini ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricular ◽  
University Hospital ◽  
Lv Function ◽  
Lamin A ◽  
Age Related ◽  
End Stage Heart Failure ◽  
Lv Volumes ◽  
End Stage

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): This work was supported by the Norwegian Research Council [203489/030] onbehalf Department of Cardiology, Research group for genetic cardiac diseases and sudden cardiac death, Oslo University Hospital, Rikshospitalet, Oslo, Norwa Background Lamin A/C disease is an inheritable cardiomyopathy characterized by conduction abnormalities, ventricular arrhythmias and end stage heart failure with complete age-related penetrance. Purpose To assess left ventricular structural and functional progression in patients with lamin A/C cardiomyopathy. Methods We included and followed consecutive lamin A/C genotype positive patients with clinical examination and echocardiography at every visit. We evaluated progression of left- ventricular size and function by mixed model statistics. Results We included 101 consecutive lamin A/C genotype positive patients (age 44 [29-54] years, 39% probands, 51%female) with 576 echocardiographic exams during 4.9 (IQR 2.5-8.1) years of follow-up. LV ejection fraction (LVEF) declined from 50 ± 12% to 47 ± 13%, p &lt; 0.001 (rate -0.5%/year). LV end diastolic volumes (LVEDV) remained stationary with no significant dilatation in the total population (136 ± 45ml to 138 ± 43ml, p = 0.60), (Figure). In the subgroup of patients &gt;58 years, we observed a decline in LV volumes 148, SE 9 ml to 140, SE 9 ml p &lt; 0.001 (rate -2.7 ml/year) towards end stage heart failure. Conclusions LVEF deteriorated, while LV size remained unchanged during 4.9 years of follow-up in patients with lamin A/C cardiomyopathy. In patients &lt;58 years, we observed a reduction in LV volumes. These findings represent loss of LV function without the necessary compensatory dilation to preserve stroke volume indicating high risk of decompensated end stage heart failure in lamin A/C. Abstract Figure.

scholarly journals Role of nurses to improve self-care in heart failure patients: a systematic review and meta-analysis

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Massimi ◽  
C De Vito ◽  
M L Rega ◽  
P Villari ◽  
G Damiani
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Meta Analysis ◽  
Self Care ◽  
Educational Interventions ◽  
Management Skills ◽  
Short Term ◽  
Post Discharge ◽  
Individual Level ◽  
Heart Failure Patients

Abstract Introduction Heart Failure (HF) is a pandemic chronic disease with a prevalence up to 3% in the general population, representing the main cause of hospitalization for people over 65. Self-care plays a central role in the management of patients with HF, showing evidence of effectiveness in reducing re-hospitalization rates and mortality. Methods We carried out a systematic review and meta-analysis to assess the efficacy of nurse-led educational interventions Vs usual care in improving self-care skills of patients with chronic HF. The main biomedical databases were searched for Randomized Control Trials (RCTs) of nurse-led educational interventions performed on adults with a previous diagnosis of HF. Improvement of HF self-management skills (self-care level) was summarized by calculating the standardized mean difference (SMD) and 95% confidence intervals (CI) stratified for the length of the follow-up. Results Globally, 14 RCTs were included involving 2078 participants. Ten studies showed the efficacy of the interventions at 3 months (short term) with a SMD of 0.78 (95% CI 0.38-1.18) in favor of the self-care education interventions. Five studies reported on self-care abilities at 6-9 months (medium term), not showing statistically significant results (SMD 0.35, 95%CI 0.11-0.81). The long-term effect of the educational interventions showed no statistically significant improvement in self-care behaviors (three studies, SMD 0.05, 95CI% 0.12 - 0.22). Conclusions These results show that nursing educational interventions improve self-care behaviors in HF, but mainly in the short term. Intensive educational interventions led by nurses, associated with appropriate continuity and transition of care, can determine the best outcomes for patients with HF, strengthening self-care behaviors over time. This approach could have a major impact not only on individual level, but on the general reduction of complications, hospitalization, medical costs and ultimately mortality. Key messages Nurse-led educational programs have a short-term efficacy in enhancing self-care behaviors among heart failure patients. Post-discharge repeated educational interventions, along with timely and shared plans ruling the transition between the hospital and the other providers, are strongly needed.

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

2014 ◽  
Vol 16 (11) ◽  
pp. 1241-1248 ◽  
Author(s):  
Marie Louise A. Luttik ◽  
Tiny Jaarsma ◽  
Peter Paul van Geel ◽  
Maaike Brons ◽  
Hans L. Hillege ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Heart Failure Patients ◽  
Heart Failure Clinic ◽  
Long Term Follow Up

scholarly journals Pharmacist-Led Transition of Care Interventions Identify and Reduce Medication Errors in Heart Failure Patients Post-Discharge

2016 ◽  
Vol 22 (8) ◽  
pp. S134-S135
Author(s):  
Michelle Fine ◽  
R. Kannan Mutharasan ◽  
Preeti Kansal ◽  
Hannah Alphs Jackson ◽  
Corrine Benacka ◽  
...  
Keyword(s):  
Heart Failure ◽  
Medication Errors ◽  
Transition Of Care ◽  
Post Discharge ◽  
Heart Failure Patients

scholarly journals Clinical and laboratory follow-up after hospitalization for COVID-19 at an Italian tertiary care center

2021 ◽  
Author(s):  
Michele Spinicci ◽  
Iacopo Vellere ◽  
Lucia Graziani ◽  
Marta Tilli ◽  
Beatrice Borchi ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Care Center ◽  
Tertiary Care ◽  
University Hospital ◽  
Tertiary Care Center ◽  
Persistent Symptom ◽  
Post Discharge

Abstract We evaluated 100 post-acute COVID-19 patients, a median of 60 days (IQR 48-67) after discharge from the Careggi University Hospital, Italy. Eighty-four (84%) had at least one persistent symptom, irrespective of COVID-19 severity. A considerable number of hospital re-admission (10%) and/or infectious diseases (14%) during the post-discharge period was reported.

scholarly journals Diagnosis, treatment, and follow-up of heart failure patients by general practitioners: A Delphi consensus statement

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244485
Author(s):  
Caroline Verhestraeten ◽  
Gijs Weijers ◽  
Daphne Debleu ◽  
Agnieszka Ciarka ◽  
Marc Goethals ◽  
...  
Keyword(s):  
Heart Failure ◽  
General Practitioner ◽  
General Practitioners ◽  
Early Stage ◽  
Blood Analysis ◽  
Care Process ◽  
Delphi Panel ◽  
Delphi Consensus ◽  
Heart Failure Patients

Aims Creation of an algorithm that includes the most important parameters (history, clinical parameters, and anamnesis) that can be linked to heart failure, helping general practitioners in recognizing heart failure in an early stage and in a better follow-up of the patients. Methods and results The algorithm was created using a consensus-based Delphi panel technique with fifteen general practitioners and seven cardiologists from Belgium. The method comprises three iterations with general statements on diagnosis, referral and treatment, and follow-up. Consensus was obtained for the majority of statements related to diagnosis, referral, and follow-up, whereas a lack of consensus was seen for treatment statements. Based on the statements with good and perfect consensus, an algorithm for general practitioners was assembled, helping them in diagnoses and follow-up of heart failure patients. The diagnosis should be based on three essential pillars, i.e. medical history, anamnesis and clinical examination. In case of suspected heart failure, blood analysis, including the measurement of NT-proBNP levels, can already be performed by the general practitioner followed by referral to the cardiologist who is then responsible for proper diagnosis and initiation of treatment. Afterwards, a multidisciplinary health care process between the cardiologist and the general practitioner is crucial with an important role for the general practitioner who has a key role in the up-titration of heart failure medication, down-titration of the dose of diuretics and to assure drug compliance. Conclusions Based on the consensus levels of statements in a Delphi panel setting, an algorithm is created to help general practitioners in the diagnosis and follow-up of heart failure patients.

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