Efficacy of an Integrated Hospital-primary Care Program for Heart Failure: A Population-based Analysis of 56 742 Patients

Comín‐Colet, Josep; Verdú-Rotellar, José María; Vela, Emili; Clèries, Montse; Bustins, Montse; Mendoza, Lola; Badosa, Neus; Cladellas, Mercè; Ferré, Sofía; Bruguera, Jordi

doi:10.1016/j.rec.2013.12.005

Cited by 53 publications

(94 citation statements)

References 29 publications

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“…17,18 In this type of unit or program, a variety of interventions may be carried out (education, follow-up, treatment, social support) from those that have been demonstrated to improve quality of life, reduce the number of hospital admissions for HF and for all causes, and even reduce mortality. 5,6 This reduction in hospital admissions 4,14,15,[19][20][21] and improved survival have also been demonstrated in Spain.…”

Section: Introductionmentioning

confidence: 74%

“…Theoretically, these models help ensure that the scientific evidence is applied homogeneously without variation, thereby helping to raise the bar for quality of care and increase the equity of our health care system. [4][5][6][7][13][14][15] Within the general framework of HFUs, multiple models of care have been described, ranging from a single educational session before discharge or a single educational home visit by a specialist nurse and regular telephone follow-up to a multidisciplinary intervention centralized in a physical unit, with or without interaction with primary care (PC). Most HFUs combine several of these interventions.…”

Section: Introductionmentioning

confidence: 99%

“…Most HFUs combine several of these interventions. [4][5][6][7][13][14][15][16] The increasing use of these care systems has been perceived favorably due to the initial results from many studies and meta-analyses, 5,6 leading to their level IA recommendation in clinical practice guidelines. 17,18 In this type of unit or program, a variety of interventions may be carried out (education, follow-up, treatment, social support) from those that have been demonstrated to improve quality of life, reduce the number of hospital admissions for HF and for all causes, and even reduce mortality.…”

Section: Introductionmentioning

confidence: 99%

“…Despite these limitations, we believe that there are some basic key components that should form the basis of all HF programs or HFUs (Table 1). [4][5][6][7]17,18 Widespread implementation of these integrated care models for patients with HF has been difficult for several reasons. Such reasons include the heterogeneity of the models evaluated in clinical trials, the questionable applicability of study results in ''real world'' clinical practice, and their organizational complexity.…”

Section: Introductionmentioning

confidence: 99%

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Transitions of Care Between Acute and Chronic Heart Failure: Critical Steps in the Design of a Multidisciplinary Care Model for the Prevention of Rehospitalization

Comín‐Colet

Enjuanes

Lupón

et al. 2016

Revista Española de Cardiología (English Edition)

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Despite advances in the treatment of heart failure, mortality, the number of readmissions, and their associated health care costs are very high. Heart failure care models inspired by the chronic care model, also known as heart failure programs or heart failure units, have shown clinical benefits in high-risk patients. However, while traditional heart failure units have focused on patients detected in the outpatient phase, the increasing pressure from hospital admissions is shifting the focus of interest toward multidisciplinary programs that concentrate on transitions of care, particularly between the acute phase and the postdischarge phase. These new integrated care models for heart failure revolve around interventions at the time of transitions of care. They are multidisciplinary and patient-centered, designed to ensure continuity of care, and have been demonstrated to reduce potentially avoidable hospital admissions. Key components of these models are early intervention during the inpatient phase, discharge planning, early postdischarge review and structured follow-up, advanced transition planning, and the involvement of physicians and nurses specialized in heart failure. It is hoped that such models will be progressively implemented across the country.

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Section: Introductionmentioning

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Transitions of Care Between Acute and Chronic Heart Failure: Critical Steps in the Design of a Multidisciplinary Care Model for the Prevention of Rehospitalization

Comín‐Colet

Enjuanes

Lupón

et al. 2016

Revista Española de Cardiología (English Edition)

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“…En nuestro entorno se observan resultados similares en proyectos realizados de forma conjunta entre el medio hospitalario y atención primaria, apreciándose descensos en la tasa de mortalidad menores que en nuestro estudio, pero disminuyendo de manera significativa el número de reingresos 19,20 . Inclusive, algunos estudios hablan de una relación directa entre el nú-mero de reingresos y el mayor uso de BB 21 .…”

Section: B Aunclassified

Utilidad de los programas de intervención en el control evolutivo de los pacientes con insuficiencia cardiaca

Flamarique-Pascual¹,

Esteban‐Zubero

Ruiz‐Ruiz³

et al. 2017

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ResumenLa insuficiencia cardiaca (IC) Blesa, in Zaragoza, Spain, diagnosed of HF between November 2013 and October 2014 (both Abstract Acute heart failure (HF) is a prevalent disease with important socio-economic repercussions. Due to the aging of population, these values will increase in the coming years, so it may be useful to the implementation of intervention programs in these patients to decrease morbidity and mortality. A quasi-experimental prospective study (n = 262) of patients admitted at the Internal Medicine Department of the Hospital Clínico Universitario Lozano

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Study design of Heart failure Events reduction with Remote Monitoring and eHealth Support (HERMeS)

et al. 2020

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Aims The role of non-invasive telemedicine (TM) combining telemonitoring and teleintervention by videoconference (VC) in patients recently admitted due to heart failure (HF) ('vulnerable phase' HF patients) is not well established. The aim of the Heart failure Events reduction with Remote Monitoring and eHealth Support (HERMeS) trial is to assess the impact on clinical outcomes of implementing a TM service based on mobile health (mHealth), which includes remote daily monitoring of biometric data and symptom reporting (telemonitoring) combined with VC structured, nurse-based follow-up (teleintervention). The results will be compared with those of the comprehensive HF usual care (UC) strategy based on face-to-face on-site visits at the vulnerable post-discharge phase. Methods and results We designed a 24 week nationwide, multicentre, randomized, controlled, open-label, blinded endpoint adjudication trial to assess the effect on cardiovascular (CV) mortality and non-fatal HF events of a TM-based comprehensive management programme, based on mHealth, for patients with chronic HF. Approximately 508 patients with a recent hospital admission due to HF decompensation will be randomized (1:1) to either structured follow-up based on face-to-face appointments (UC group) or the delivery of health care using TM. The primary outcome will be a composite of death from CV causes or non-fatal HF events (first and recurrent) at the end of a 6 month follow-up period. Key secondary endpoints will include components of the primary event analysis, recurrent event analysis, and patient-reported outcomes. Conclusions The HERMeS trial will assess the efficacy of a TM-based follow-up strategy for real-world 'vulnerable phase' HF patients combining telemonitoring and teleintervention.

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Efficacy of an Integrated Hospital-primary Care Program for Heart Failure: A Population-based Analysis of 56 742 Patients

Cited by 53 publications

References 29 publications

Transitions of Care Between Acute and Chronic Heart Failure: Critical Steps in the Design of a Multidisciplinary Care Model for the Prevention of Rehospitalization

Transitions of Care Between Acute and Chronic Heart Failure: Critical Steps in the Design of a Multidisciplinary Care Model for the Prevention of Rehospitalization

Utilidad de los programas de intervención en el control evolutivo de los pacientes con insuficiencia cardiaca

Study design of Heart failure Events reduction with Remote Monitoring and eHealth Support (HERMeS)

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