Philadelphia, PA, July 19, 2012 Outpatient heart failure (HF) clinics that provide patient education on ways to manage heart failure and risk factors, prescribe home-based exercises, and monitor therapy compliance have been shown to reduce morbidity, mortality, and health care costs. A new study published in the current issue of the Canadian Journal of Cardiology finds that despite guidelines that encourage physicians to recommend heart failure clinics, very few patients recently hospitalized with HF receive referrals or use one.
"Given the demonstrated benefits of these services, the rates of referral and enrollment in our study are discouragingly low," says lead investigator Shannon Gravely, PhD, York University, University Health Network, and Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
The investigators recruited 474 HF inpatients from 11 hospitals across Ontario. The patients completed a survey that evaluated environmental and individual factors affecting HF clinic use. Environmental factors included hospital type, whether the hospital had an onsite HF clinic, and whether the patient had been referred to other outpatient disease management programs (DMP), such as smoking cessation clinics or diabetes education. Individual factors included sociodemographic information, whether the patient lived in a rural area, marital status, perceived stress, and depressive symptoms. Clinical indicators of the need for rehabilitative services were gathered from patient charts. A year after the first survey, the patients received a second survey and reported whether they had been referred to an HF clinic, and if they had attended. 270 patients completed the follow-up survey and were included in the analysis.
Results showed that 15% of study participants were referred to, and 13% reported using an HF clinic. Patients with higher education were five times more likely to use an outpatient HF clinic compared to thos
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