Journal of the Hong Kong College of Cardiology

Volume 12 Number 1 / 2, January / April 2004
Abstract

Impact of a Multidisciplinary Heart Failure Management Programme on Clinical Outcomes and Hospital Admissions

Tat-chi Leung,1 Chung-tai Sy,1 May Shuk-mai Lam,1 Kam-wah Wong,2 Sai-ho Dai,3 Pui-yee Law,4 Shu-kin Li1
From 1Department of Medicine, 2Department of Physiotherapy, 3Department of Occupational Therapy, 4Department of Dietetic, Pamela Youde Nethersole Eastern Hospital, Hong Kong

LeunG et al.: Impact of a Multidisciplinary Heart Failure Management Programme on Clinical Outcomes and Hospital Admissions. Objectives: Heart failure is associated with significant morbidity and high admission rate. We evaluated the impact of a multidisciplinary heart failure management programme in a regional hospital. Methods: From March 2001 to January 2003, fourteen patients with heart failure and history of >= 1 hospitalization for heart failure in the previous 6 months were recruited. Patients attended the programme twice per week for 3 months. Patients were cared by a multidisciplinary team including cardiologist, geriatrician, registered nurse, physiotherapist, occupational therapist and dietitian. All patients were counseled on different aspects about heart failure and received exercise training. Medications for heart failure were optimized. Knowledge of the disease, drug compliance, functional class, exercise capacity and quality of life were assessed before and after the programme. Number of heart failure hospitalization and the cost of care within the 6 months before enrolment were compared to that within the 6 months after enrolment. Results: The number of hospitalization for heart failure was reduced significantly from 28 to 6 (a reduction of 78.6%, p<0.001). Knowledge score, drug compliance score, New York Heart Association (NYHA) class, 6-minute walk and quality of life scores all improved significantly. An estimated cost saving of HK$11,340 per patient was achieved over a 6-month time frame (reduction of in-patient costs by HK$35,880 per patient and an increase in outpatient costs by HK$24,540 per patient). Conclusions: Multidisciplinary heart failure management programme is feasible in our locality. It can improve clinical outcomes; reduce heart failure hospitalizations and the high cost burden of this condition. (J HK Coll Cardiol 2004;12:16-22)

Key words : Cardiac rehabilitation, exercise, heart failure, multidisciplinary approach



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