Skip to main content

Implementation and certification of a heart failure clinical care program in a middle income country: impact in clinical outcomes after 2 years

Introduction

Clinical care programs (CCP) that monitor and optimize care have the potential to improve outcomes; however, their real benefits are still controversial.

Objective

This study aims to evaluate the hypothesis of benefits in clinical outcomes after 2 years of a CCP.

Methods

Prospective study of consecutive patients hospitalized with HF in a Brazilian private cardiovascular center. Two groups were compared based on the time to CCP initiation: the historical group, compounded by patients from the 6 months prior to CCP (group 1); and the intervention group, compounded by patients admitted with diagnosis of HF from July 2012 until June 2014, the period when patients and staff were monitored on a daily basis by a case manager nurse and a medical leader which provided educational interventions. The CCP was certified by an international society in October 2012.

Results

In a total of 2188 patients, the mean age was 69.3 years and 55.8% were male (Table 1). Evidence-based therapies at hospital discharge (ACEI/ARB and beta-blocker in eligible patients) showed no significant change (95.8% pre-CCP and 97.5% post-CCP; p = 0.12). The outcomes analyzed in groups 1 and 2, were, respectively: hospital readmissions due to HF within 30 days (13.9% vs. 9.1%; p = 0.008); length of stay (8.9 ± 7.9 days vs. 7.9 ± 5.6 days, p = 0.01); decompensation of HF by poor adherence (16.8% vs. 10.5%; p = 0.001); and in-hospital mortality (9% vs. 6.9%; p = 0.24).

Table 1

Conclusion

During the 2 years of the CCP there was a reduction of 1 day in the length of stay, and a lower frequency of hospitalizations by poor treatment adherence, and in readmissions in 30 days.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Pedro Gabriel MB Silva.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

MB Silva, P.G., Baruzzi, A., Ribeiro, D. et al. Implementation and certification of a heart failure clinical care program in a middle income country: impact in clinical outcomes after 2 years. Crit Care 19, P8 (2015). https://doi.org/10.1186/cc14664

Download citation

Keywords

  • Hospital Discharge
  • Case Manager
  • International Society
  • Middle Income Country
  • Income Country