Navigation Links
Despite clear benefits, heart failure clinics are rarely utilized
Date:7/19/2012

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 those with lower education. Lower stress levels and more serious health conditions were also associated with HF use. Patients who received a referral to another DMP were nearly five times more likely to use an HF clinic. The most important factor in determining whether a patient used an HF clinic was the presence of an established program at the patient's original hospital. "It's likely that having an HF clinic on-site is related to greater awareness of the benefits of such services by physicians providing care. However, broader referral mechanisms are needed to ensure that all patients, regardless of where they receive care, have equitable access to HF clinics," says Dr. Gravely.

In a related study published in the same issue, Dr. Gravely and colleagues examined more broadly the use of DMPs by patients with cardiovascular disease (CVD). 1,803 hospitalized patients completed a survey about factors that influenced DMP use and a follow-up study a year later that assessed whether they had used any DMPs: cardiac rehabilitation, outpatient diabetes education, an HF clinic, stroke rehabilitation, or a smoking cessation program.

Overall, roughly 40% of patients did not access any post-acute DMPs. Fifty percent accessed one program, and 10% attended more than one. Among participants with a comorbid indication (diabetes, stroke, heart failure, or smokers), 21% of these participants reported that they used multiple programs. DMP participants were younger, more likely to be married, and more highly educated than those who did not attend DMPs. Overall, 53% reported participating in cardiac rehabilitation, and among participants with a comorbid illness or risk, 41% of diabetics reported attending a diabetes education center, 26% of stroke patients attended stroke rehabilitation, 13% of patients with a heart failure diagnosis used a heart failure clinic, and 12% of smokers attended a smoking cessation program. Among all study participants these findings suggest a gross underuse of DMP services, particularly stroke rehabilitation, HF clinics, and most notably, smoking cessation programs.

"What is one of the most concerning findings is that only 12% of current smokers reported taking part in a smoking cessation program," notes Dr. Gravely. "Participation in smoking cessation programs results in significantly higher cessation rates when compared with standard care."

Dr. Gravely notes that future research is needed to explore not only patient-related factors, but also health-system factors such as awareness and capacity that may be at play. "The appropriateness and cost repercussions of multiple DMP use should be investigated, as an integrated approach to vascular disease management may be warranted," she concludes.


'/>"/>

Contact: Erika Brown-Schumann
e.schumann@elsevier.com
215-239-3704
Elsevier
Source:Eurekalert

Related medicine news :

1. Despite hardships, black men in urban communities are resilient, MU researcher says
2. Despite less play, childrens use of imagination increases over 2 decades
3. Many Still Tanning, Despite Dangers, Survey Finds
4. Helper T cells, not killer T cells, might be responsible for clearing hepatitis A infection
5. DBT Expert Charles Swenson to Present at Upcoming Clearview Workshop
6. San Francisco Bath Salt Company Clears Air About Bath Salt Confusion – Zombies Beware!
7. Piramal imaging to present data at Society for Nuclear Medicine Annual Meeting
8. FDA clears test developed in partnership with VCU researcher
9. Role of Screening, Monitoring in Early Kidney Disease Unclear
10. Passengers on Bat Plane Cleared of Rabies Risk
11. Stressful Jobs Linked to Heart Woes in Women
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... (PRWEB) , ... October 13, 2017 , ... ... will be giving viewers the lowdown on sciatica in a new episode of ... that focuses on current events and innovation and investigates each subject in-depth with ...
(Date:10/13/2017)... ... 13, 2017 , ... “America On The Brink”: the Christian history of the ... is the creation of published author, William Nowers. Captain Nowers and his wife, ... he spent thirty years in the Navy. Following his career as a naval ...
(Date:10/12/2017)... ... October 12, 2017 , ... Planet Fitness, one of ... announced today its plans to open a flagship location in Covington, LA at 401 ... Rooms To Go store next to Office Depot in the Holiday Square shopping center. ...
(Date:10/12/2017)... ... 2017 , ... The American College of Medical Informatics (ACMI) will present the ... Opening Session of AMIA’s Annual Symposium in Washington, D.C. AMIA’s Annual Symposium ... a pioneer in the field of medical informatics, this prestigious award is presented to ...
(Date:10/12/2017)... , ... October 12, 2017 , ... ... Hair Restoration, has recently contributed a medical article to the newly revamped ... Dr. Mohebi’s article spotlights the hair transplant procedure known as Follicular Unit ...
Breaking Medicine News(10 mins):
(Date:9/19/2017)... ARBOR, Mich. , Sept. 19, 2017 HistoSonics, Inc., a venture-backed medical device ... precise destruction of targeted tissues, announced three leadership team developments today:   ... Stopek, PhD ... ... Veteran medical device executive ...
(Date:9/18/2017)... ALLENTOWN , Pa. and KALAMAZOO, Mich. ... Allentown, Penn. , and OptiMed Specialty Pharmacy ... a business partnership to offer a strategic hub service ... PMD Healthcare,s highly sought-after personal spirometer, Spiro PD 2.0, ... A spirometer is a medical device used ...
(Date:9/13/2017)... , Sept. 13, 2017   OrthoAtlanta has been ... Atlanta Football Host Committee (AFHC) for the 2018 College Football ... 8, 2018, at Mercedes-Benz Stadium in Atlanta, Georgia ... the AFHC "I,m In" campaign, participating in many activities leading ... ...
Breaking Medicine Technology: