Clinical InvestigationCongestive Heart FailurePilot study to determine the impact of a multidisciplinary educational intervention in patients hospitalized with heart failure
Section snippets
Participants
Patients admitted to the London Health Sciences Centre, Victoria Campus, were eligible if they had HF documented with a low left ventricular ejection fraction (LVEF ≤ 40%), had indications for long-term medical treatment of HF or low LVEF, and provided informed consent as approved by the university-based institutional ethics review board (09091E) (Table I). Patients were excluded if they were <18 years old, were receiving dialysis, had dementia or psychiatric illness, suffered from another
Results
Figure 1 describes the flow of patients through the trial. Our search strategy to facilitate recruitment to the trial was a broad-based approach that essentially targeted any patient with an admission diagnosis of HF, signs or symptoms that may have a differential diagnosis of HF, or a previous discharge diagnosis of HF. Inclusion and exclusion criteria were then applied to the population to derive an eligible study population, yielding 128 patients for evaluation.
Discussion
This multidisciplinary inhospital educational intervention improved knowledge and disease-specific HRQoL acutely, and the effects persisted for 1 year. We were unable to show an effect on compliance, generic HRQoL, or time to event over the 1-year follow-up in this pilot study. It is not surprising that the SF-36 does not have the responsiveness to detect disease-specific changes, as this has consistently been noted in the literature.16 Although measures of mean compliance suggested high
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2023, Joint Commission Journal on Quality and Patient Safety2020 ACC/AHA Clinical Performance and Quality Measures for Adults With Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures
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2019, Journal of Cardiac FailureCitation Excerpt :Among the 9 RCTs, only 4 studies reported a significant improvement and difference in health-related quality of life in HF patients. The quality of life was measured by different instruments: the Chronic Heart Failure Questionnaire,47 EuroQol- 5 Dimension,44,49 the Minnesota Living With Heart Failure (MLHF),45,46,49,50,68,70,72 the 36-Item Short Form Health Survey (SF-36),45,50,68,70 the Dartmouth Primary Care Cooperative Information Project/World Organizations of National Colleges, Academics, Academic Associations of General Practice/Family Physicians,46 and the 15-item Geriatric Depression Scale.70 There are no small studies on the bottom right of the funnel plot of HF hospitalizations so that the typical inverted funnel-like shape was not observed indicating the presence of some degree of publication bias (supplementary Fig. S2a).
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