Open Access to an Outpatient Intravenous Diuresis Program in a Systolic Heart Failure Disease Management Program

Hebert, Kathy; Dias, André; Franco, Emiliana; Tamariz, Leonardo; Steen, Dylan; Arcement, Lee M.

doi:10.1111/j.1751-7133.2011.00224.x

Cited by 31 publications

(28 citation statements)

References 9 publications

(6 reference statements)

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“…[125][126][127][128][129] In addition, HF hospitalization was reduced. Ryder and colleagues 126 found that 72% of patients were stabilized and did not require hospitalization, 124 and Banerjee and colleagues 129 noted that 94% of patients were not admitted within 28 days following their outpatient IV diuresis regimen. [126][127][128] Unsurprisingly, considerable cost savings were noted when hospitalization was not required.…”

Section: Advance Care Planning Outpatient Intravenous Diuresismentioning

confidence: 98%

“…83,122,123 Outpatient intravenous (IV) diuretics can be used as palliative support for stage C or D refractory patients to relieve congestive symptoms. Minimal data are available regarding outpatient IV diuresis 121,124 and are limited to mainly small retrospective or nonrandomized studies. Safety of outpatient IV diuresis has been demonstrated, and in some study participants it decreased congestive symptoms, increased fluid weight loss, and improved NYHA class.…”

Section: Advance Care Planning Outpatient Intravenous Diuresismentioning

confidence: 99%

“…126,127,129 Inotropes Approximately 5% of the HF population is considered end-stage (stage D), or having refractory symptoms despite maximal medical therapy. 124,126,127,130,131 Many stage D patients are hospitalized with an acute exacerbation of symptoms. In a global survey of 666 hospitals, 39% of all hospital admissions for acute HF used inotropic therapies.…”

Section: Advance Care Planning Outpatient Intravenous Diuresismentioning

confidence: 99%

“…126,127,129 Further benefit was seen when outpatients receiving IV diuretics were linked with an HF disease management program. 124,126,127,129 Patients at high risk for recurrent HF exacerbation were closely monitored and able to receive an immediate response to changes in clinical status. An essential component of IV diuretic programs is frequent patient reassessment by HF specialists within days following outpatient IV diuresis to determine overall response and the need for diuretic adjustment.…”

Section: Advance Care Planning Outpatient Intravenous Diuresismentioning

confidence: 99%

See 3 more Smart Citations

Team-Based Care for Outpatients with Heart Failure

Creaser

DePasquale

Vandenbogaart

et al. 2015

Heart Failure Clinics

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Section: Advance Care Planning Outpatient Intravenous Diuresismentioning

confidence: 98%

Section: Advance Care Planning Outpatient Intravenous Diuresismentioning

confidence: 99%

Section: Advance Care Planning Outpatient Intravenous Diuresismentioning

confidence: 99%

Section: Advance Care Planning Outpatient Intravenous Diuresismentioning

confidence: 99%

See 2 more Smart Citations

Team-Based Care for Outpatients with Heart Failure

Creaser

DePasquale

Vandenbogaart

et al. 2015

Heart Failure Clinics

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“…In a study of Medicare claims data from 2003 to 2004, nearly 27% of patients discharged with a primary diagnosis of ADHF were readmitted within 30 days [4]. The majority of patients who present to the emergency department with ADHF are admitted for inpatient treatment [5, 6]. …”

Section: Introductionmentioning

confidence: 99%

Physician-Directed Heart Failure Transitional Care Program: A Retrospective Case Review

et al. 2013

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BackgroundDespite a variety of national efforts to improve transitions of care for patients at risk for rehospitalization, 30-day rehospitalization rates for patients with heart failure have remained largely unchanged.MethodsThis is a retrospective review of 73 patients enrolled in our hospital-based, physican-directed Heart Failure Transitional Care Program (HFTCP). This study evaluated the 30- and 90- day readmission rates before and after enrollment in the program. The Transitionalist’s services focused on bedside consultation prior to hospital discharge, follow-up home visits within 72 hours of discharge, frequent follow-up phone calls, disease-specific education, outpatient intravenous diuretic therapy, and around-the-clock telephone access to the Transitionalist.ResultsThe pre-enrollment 30-day readmission rates for acute decompensated heart failure (ADHF) and all-cause readmission was 26.0% and 28.8%, respectively, while the post-enrollment rates for ADHF and all-cause readmission were 4.1% (P < 0.001) and 8.2% (P = 0.002), respectively. The pre-enrollment 90-day all-cause and ADHF readmission rates were 69.8%, and 58.9% respectively, while the post-enrollment rates for all-cause and ADHF were 27.3% (P < 0.001) and 16.4% (P < 0.001) respectively.ConclusionsOur physician-implemented HFTCP reduced rehospitalization risk for patients enrolled in the program. This program may serve as a model to assist other hospital systems to reduce readmission rates of patients with HF.

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Outpatient Worsening Heart Failure as a Target for Therapy

2018

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As the public health and economic burdens of heart failure continue to grow, recognizing the entity of outpatient WHF is critical. Efforts to reduce heart failure hospitalization should include developing effective therapies and care strategies for outpatient WHF. The outpatient WHF population represents a major opportunity for therapeutic advancements that could fundamentally change heart failure care delivery.

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Open Access to an Outpatient Intravenous Diuresis Program in a Systolic Heart Failure Disease Management Program

Cited by 31 publications

References 9 publications

Team-Based Care for Outpatients with Heart Failure

Team-Based Care for Outpatients with Heart Failure

Physician-Directed Heart Failure Transitional Care Program: A Retrospective Case Review

Outpatient Worsening Heart Failure as a Target for Therapy

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