Abstract 17804: Does Cardiologist Lead Enhanced Heart Failure Education and Follow-up Program Affect Cardiovascular Mortality Rate?: Hit-Point
Introduction: There are several different heart failure (HF) management programs; most of them are costly and are not feasible to use in various geographic areas.The aim of this study was to assess the efficacy and feasibility of a cardiologist lead enhanced HF education at the time of hospital discharge with a 6 month phone follow- up program in chronic HF patients.
Methods: The Hit Point trial was a multicenter, randomized, controlled trial of enhanced HF education with a 6 month phone follow-up program (EHFP) vs routine care (RC) in patients who carried the diagnosis of HF secondary to systolic dysfunction, had been hospitalized for HF within 6 months of randomization, and had symptoms despite optimal medical therapy. Education included information on the adherence to treatment, symptoms recognition, diet and fluid intake, weight monitoring, activity, exercise training and when to contact cardiologist. Patients were contacted by phone at 1, 3 and 6 month. The primary study endpoint was cardiovascular death.
Results: A total of 248 patients from 10 centers in various geographical areas were randomized: 125 to EHFP and 123 to RC. The mean age was 60.8±13.8 years; predominantly men (73%) with NYHA class II - IV heart failure symptoms who had a mean ejection fraction of 26%. Demographic characteristics, including age, sex, laboratory evaluations and assessments of cardiac function, and functional capacity were equivalent in both treatment groups. Use of pharmacologic therapy at baseline in the patients demonstrated compliance with AHA guideline recommendations. Six-month cardiovascular mortality was significantly higher in the RC group (p<0.05). The mean number of hospitalization was 0.58±0.91 in EHFP and 0.64±1.05 in RC (p=NS) and the mean number of emergency room visits were 0.84±1.15 and 1.21±1.47, respectively at 6-month follow-up (P<0.05). The mean number of HF hospitalization was 0.38±0.69 in EHFP and 0.45±0.86 in RC (p=NS). Thirty percent in EHFP, 29% in RC have been hospitalized due to HF (p=NS).
Conclusion: Our study results showed that an enhanced education lead by a cardiologist with a phone follow up program significantly reduced the cardiovascular deaths and number of emergency room visit within 6 months after discharge in HF patients.
- © 2013 by American Heart Association, Inc.