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. 2017 Apr;34(4):14-19.

A Heart Failure Management Program Using Shared Medical Appointments

Allison J Carroll  1 , Hillary L Howrey  2 , Susan Payvar  3 , Kristen Deshida-Such  3 , Mayank Kansal  3 , Charanjit K Brar  3
Affiliations

A Heart Failure Management Program Using Shared Medical Appointments

Allison J Carroll et al. Fed Pract. 2017 Apr.

Abstract

Background: Disease management programs for heart failure (HF) effectively reduce HF-related hospitalization rates and mortality. Shared medical appointments (SMAs) offer a cost-effective delivery method for HF disease management programs. However, few studies have evaluated this cost-effective delivery method of HF disease management among Veterans with acute HF. We hypothesized that Veterans who attended a multidisciplinary HF-SMA clinic promoting HF self-management, compared those who only received individual treatment through the HF specialty clinic, would have better 12-month hospitalization outcomes.

Methods: We completed a retrospective review of the VA electronic health record for HF-SMA clinic appointments (1/1/2012 to 12/31/2013). The multidisciplinary HF-SMA program comprised 4 weekly sessions covering topics including HF disease, HF medications, diet adherence, physical activity, psychological well-being, and stress management. Patients who attended the HF-SMA clinic (n=54) were compared to patients who were scheduled for an HF-SMA appointment but never attended and were followed only in the HF clinic (n=37). Outcomes were 12-month HF-related and all-cause hospitalization rates, days in the hospital, and time to first hospitalization.

Results: Of 141 patients scheduled for an HF-SMA clinic appointment, 54 met criteria for the HF-SMA clinic group and 37 were included in the HF clinic group. The groups did not significantly differ on any sociodemographic variables. Furthermore, no significant differences were observed between the HF-SMA group and the HF clinic group on demographics or hospitalization outcomes, p>.05 for all comparisons.

Conclusions: Our results did not support our hypothesis that offering multidisciplinary, HF-SMAs promoting HF self-management skills, above and beyond the individual disease management care provided in an HF specialty clinic, would improve hospitalization outcomes among Veterans with acute HF. Limitations of the present study and recommendations for HF self-management programs for Veterans are discussed.

Keywords: disease management; heart failure; patient education; shared medical appointment.

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Conflict of interest statement

Conflict of interest statement: The authors do not have any conflicts of interest to disclose with respect to the research, authorship, or publication of this article.

Figures

Figure
Figure
Patient Flowchart Abbreviations: HF, heart failure; SMA, shared medical appointment.
See this image and copyright information in PMC

References

    1. Boccuti C, Casillas G. Aiming for fewer hospital U-turns: the Medicare hospital readmissions reduction program. [Accessed March 6, 2017]. http://kff.org/medicare/issue-brief/aiming-for-fewer-hospital-u-turns-th.... Published September 30, 2016.
    1. Barrett ML, Wier LM, Jiang HJ, Steiner CA. All-cause readmissions by payer and age, 2009–2013. Statistical Brief #199. [Accessed March 6, 2017]. https://www.hcup-us.ahrq.gov/reports/statbriefs/sb199-Readmissions-Payer.... Published December 2015.
    1. Fingar K, Washington R. Trends in hospital readmissions for four high-volume conditions, 2009–2013. Statistical Brief #196. [Accessed March 6, 2017]. https://www.hcup-us.ahrq.gov/reports/statbriefs/sb196-Readmissions-Trend.... Published November 2015.
    1. McMurray JJ, Adamopoulos S, Anker SD, et al. ESC Committee for Practice Guidelines. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2012;33(14):1787–1847. - PubMed
    1. Wakefield BJ, Boren SA, Groves PS, Conn VS. Heart failure care management programs: a review of study interventions and meta-analysis of outcomes. J Cardiovasc Nurs. 2013;28(1):8–19. - PubMed

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