Abstract

ZUZARTE¹, Pedro et al. Outpatient disease management program for heart failure:: a multidisciplinary approach with an ambulatory intravenous diuretic therapy. Insuf. card. [online]. 2018, vol.13, n.1, pp.2-9. ISSN 1852-3862.

Aims. Heart failure (HF) is one of the most common causes of hospitalization, has high mortality and represents an economic burden. The Heart Failure Disease Management Program (HFDMP) at Health Sciences North (HSN) was designed and implemented utilizing various outpatient strategies aimed to help patients avoid emergency department (ED) visits, lower HF hospitalizations, improve outcomes, decrease mortality and lower health care costs. This study was designed to evaluate the effectiveness and safety of this program. Methods and results. 138 patients were enrolled in the HFDMP over a period of 12-months. Patient outcomes, admission, readmission and mortality rates were observed to determine the safety, efficacy and the costs associated. Of the patients treated for acute decompensated HF (ADHF) 29 patients received 79 continuous intravenous furosemide therapy (infusions). These patients were monitored for electrolyte changes, ED visits and hospitalizations to determine the safety and efficacy of the infusion clinic (IC). During the period of study NT-proBNP, eGFR and ejection fraction among other variables were analyzed. Only five readmissions within 30 days were noted over 12 months however, none of these hospitalizations was related to ADHF. The program’s mortality rate was 3%. No patient subjected to infusions required an ED visit or hospitalization. No clinical significant electrolyte changes was seen requiring hospitalization. Conclusions. The findings from our study suggests that this outpatient approach is a safe way to manage ADHF and an effective way to avoid ED visits, lower HF hospitalizations, decrease mortality, improve clinical symptoms and lower health care utilization costs.

Keywords : Heart failure; Outpatient; Management; Hospitalization; Readmissions; Mortality; Diuretic therapy.

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