Keywords
Patient care team
Ventricular ejection fraction
Program evaluation
Health program and project evaluation
How to Cite
Abstract
Introduction: Heart failure is a chronic disease with high prevalence and high costs to the healthcare system in Colombia.
In response, heart failure units have been developed that carry out interventions through a multidisciplinary approach
with satisfactory results. Objective: To evaluate the effectiveness of heart failure program at Clínica Universitaria Colombia
after 3 months of intervention, with respect to changes in ejection fraction, functional classification, and hospital
admissions during 2019. Methods: Longitudinal analytical observational study, before and after the intervention of the
heart failure program in a retrospective cohort. The intervention consisted of follow-up within the heart failure clinic and
multidisciplinary intervention. An analysis of the initial demographic and clinical characteristics was performed, and after 3
months of follow-up, ejection fraction, functional class, and hospital admissions were evaluated. Results: 60 patients were
included, with an average age of 65,2 ±13,3 years, 61,7 % male. At admission, patients had an average ejection fraction of
34 % ±12 and after 3 months, 38 % ±13 (p <0,001). An increase of 23,4 % in the number of patients in NYHA I and a complete decrease in patients in NYHA III was found (p <0.001). There was a decrease in the number of hospitalizations from 1,7 to 1,1. Conclusions: The heart failure program is a multidisciplinary strategy with a positive impact on patients with heart
failure, resulting in reduced hospital admissions, improved functional class, and ejection fraction.
References
McDonagh TA, Metra M, Adamo M, Baumbach A, Böhm M, Burri H, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;42(36):3599-726.
Bozkurt B, Coats AJS, Tsutsui H, Abdelhamid CM,
Adamopoulos S, Albert N, et al. Universal definition and classification of heart failure: a report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure: Endorsed by the Canadian Heart Failure Society, Heart Failure Association of India, Cardiac Society of Australia and New Zealand, and Chinese Heart Failure Association. Eur J Heart Fail. 2021;23(3):352-80.
Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(18):895-1032.
Savarese G, Becher PM, Lund LH, Seferovic P, Rosano
GMC, Coats AJS. Global burden of heart failure: a comprehensive and updated review of epidemiology.
Cardiovasc Res. 2022;118(17):3272-87.
Yan T, Zhu S, Yin X, Xie C, Xue J, Zhu M, et al. Burden, Trends, and Inequalities of Heart Failure Globally, 1990 to 2019: A Secondary Analysis Based on the Global Burden of Disease 2019 Study. J Am Heart Assoc.
;12(6):027852.
Huffman M, Prabhakaran D. Heart failure: Epidemiology and prevention in India. Natl Med J India. 2010;23(5):283-288.
Hao G, Wang X, Chen Z, Zhang L, Zhang Y, Wei B, et al. Prevalence of heart failure and left ventricular dysfunction in China: the China Hypertension Survey, 2012-2015. Eur J Heart Fail. 2019;21(11): 1329-1337.
González-Pacheco H, Alvarez-Sangabriel A
Martinez-Sánchez C, Briseño-Cruz JL, Altamirano-Castillo A, Mendoza-García S, et al. Clinical phenotypes, atiologies, management, and mortality in acute heart failure: a single-institution study in Latin-America. ESC Heart Fail. 2021;8(1):423-437.
Bocchi EA, Arias A, Verdejo H, Diez M, Gómez E, Castro P.The reality of heart failure in Latin America. J Am Coll Cardiol. 2013;62(11):949-958.
Ciapponi A, Alcaraz A, Calderón M, Matta MG, Chaparro M, Soto N, et al. Carga de enfermedad de la insuficiencia cardíaca en América Latina: revisión sistemática y metanálisis. Rev Esp Cardiol. 2016;69(11):1051-1060.
Saldarriaga Cl, Garcés JJ, Agudelo A, Guarín LF, Mejía J. Impacto clínico de un programa de falla cardíaca. Rev
Colomb Cardio: 20162314) 260-26.
Gómez E. Capítulo 2. Introducción, epidemiología de la falla cardiaca e historia de las clínicas de falla cardiaca en Colombia. Rev Colomb Cardiol. 2016;23(S1):6-12.
Saldarriaga C, Gallego C, Fajardo LA, Agudelo AM,
Sánchez Zapata P, Pérez LE, et al. Multidisciplinary Heart Failure Care Program: An Experience From Colombia. Curr Probl Cardiol. 2023;48(1): 101431.
Mao CT, Liu MH, Hsu KH, Fu TC, Wang JS, Huang YY, et al. Effect of multidisciplinary disease management for hospitalized heart failure under a national health insurance programme. Journal of Cardiovascular Medicine.2015;16(9):616-624.
González G. Capítulo 4. Planificación de las clínicas de falla cardiaca, objetivos, infrastructura y personal. Rev Colomb Cardiol. 2016;23(S1):20-24.
Antonini P, Comín J, Di Somma M, Di Somma S, Enckels M, Gackowski A, et al. The Heart Failure Policy Network. Europa; 2018.
Blue L, Lang E, McMurray JJV, Davie AP, McDonagh TA, Murdoch DR, et al. Randomised controlled trial of specialist nurse intervention in heart failure. BMJ.
;323(7315):715-718.
Senior JM, Saldarriaga C, Rendón JA. Descripción clínico-epidemiológica de los pacientes con falla cardiaca aguda que consultan al servicio de urgencias. Acta Med Colomb. 2019;36(3): 125-129.
Rego R, Pereira N, Pinto A, Pereira S, Marques I. Impact of a heart failure multidisciplinary clinic on the reduction of healthcare-related events and costs: the GEstIC study. Front Cardiovasc Med. 2023;10.
Naylor MD, Brooten DA, Campbell RL, Maislin G, McCauley KM, Schwartz JS. Transitional care of older adults hospitalized with heart failure: A randomized, controlled trial. J Am Geriatr Soc. 2004;52(5):675-684.
Jaarsma T, van der Wal MHL, Lesman-Leegte I, Luttik ML, Hogenhuis J, Veeger NJ, et al. Effect of moderate or intensive disease management program on outcome in patients with heart failure: Coordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure (COACH). Arch Intern Med. 2008;168(3):316-324.
McAlister FA, Stewart S, Ferrua S, McMurray JUJV.
Multidisciplinary strategies for the management of heart failure patients at high risk for admission: A systematic review of randomized trials. J Am Coll Cardiol. 2004;44(4):810-819.
Holland R, Battersby , Harvey I, Lenaghan E, Smith J, Hay L. Systematic review of multidisciplinary interventions in heart failure. Heart. 2005;91(7):899-906.
Takeda A, Martin N, Taylor RS, Taylor SJC. Disease management interventions for heart failure. Cochrane Database Syst Rev. 2019;1(1):1-217.
Laborde-Castérot H, Agrinier N, Zannad F, Mebazaa A, Rossignol P, Girerd N, et al. Effectiveness of a multidisciplinary heart failure disease management programme on 1-year mortality. Medicine. 2016;95(37): 1-9.
Kim HN, Januzzi JL. Natriuretic peptide testing in heart failure. Circulation. 2011;123(18):2015-2019.
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