{"id":5167,"date":"2012-12-10T00:00:00","date_gmt":"2012-12-10T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/a-population-based-study-to-evaluate-the-effectiveness-of-multi-disciplinary-heart-failure-clinics-and-identify-important-service-components\/"},"modified":"2023-06-14T19:47:03","modified_gmt":"2023-06-14T23:47:03","slug":"a-population-based-study-to-evaluate-the-effectiveness-of-multi-disciplinary-heart-failure-clinics-and-identify-important-service-components","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/a-population-based-study-to-evaluate-the-effectiveness-of-multi-disciplinary-heart-failure-clinics-and-identify-important-service-components\/","title":{"rendered":"A population-based study to evaluate the effectiveness of multi-disciplinary heart failure clinics and identify important service components"},"content":{"rendered":"<p><strong>Background<\/strong> &#x2014; Multi-disciplinary heart failure (HF) clinics are efficacious in clinical trials. The researchers&#x2019; objectives were to compare real-world outcomes of HF patients treated in HF clinics vs. usual therapy and identify HF clinic features associated with improved outcomes.<\/p>\n<p><span class=\"bold\">Methods and Results<\/span> &#x2014; The service components at all HF clinics in Ontario, Canada were quantified using a validated instrument and categorized as high\/medium\/low intensity. The researchers used propensity scores to match HF clinic and control patients discharged alive after a HF readmission in 2006-07. Outcomes were mortality, and both all-cause and HF readmission. Cox-proportional hazard models were used to evaluate HF clinic level characteristics associated with improved outcomes. The researchers identified 14,468 HF patients, of whom 1,288 were seen in HF clinics. With 4 years of follow-up, 52.1% of HF clinic patients died versus 54.7% of control patients (p-value 0.02). HF clinic patients had increased readmissions (87.4% vs. 86.6% for all-cause [p-value 0.009]; 58.7% vs. 47.3% for HF-related [p-value &lt;0.001]). There was no difference between high, medium or low intensity clinics in terms of mortality, all-cause or HF readmissions. HF Clinics with greater frequency of visits (&gt; 4 contacts of significant duration over 6 months) were associated with lower mortality (HR 0.14; p-value &lt;0.0001) and hospitalization (HR 0.69; p-value 0.039). More intensive medication management was associated with lower all-cause (HR 0.46; p-value &lt;0.001) and HF readmission (HR 0.42; p-value &lt;0.001).<\/p>\n<p><strong>Conclusions<\/strong> &#x2014; In this real-world population based study, the researchers found that multi-disciplinary HF clinics are associated with a decrease in mortality but increase in readmissions.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; Multi-disciplinary heart failure (HF) clinics are efficacious in clinical trials. The researchers&#x2019; objectives were to compare real-world outcomes of HF patients treated in HF clinics vs. usual therapy and identify HF clinic features associated with improved outcomes. Methods and Results &#x2014; The service components at all HF clinics in Ontario, Canada were quantified [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[24,40,62],"migration-helper-qa-sample-set":[],"class_list":["post-5167","journal_article","type-journal_article","status-publish","hentry","topic-acute-and-emergency-services","topic-cardiovascular-disease","topic-health-services-research"],"acf":{"citation":"Wijeysundera HC, Trubiani G, Wang X, Mitsakakis N, Austin PC, Ko DT, Lee DS, Tu JV, Krahn M. <em>Circ Heart Fail<\/em>. 2013; 6(1):68-75. Epub 2012 Dec 10.","source_url":"http:\/\/circheartfailure.ahajournals.org\/content\/6\/1\/68.full.pdf+html","ices_scientist":[1133,1385,1146,1290],"site":[6733,6735],"research_program":[6742,6746],"news_release":[7434],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"4945C59B-92D4-4308-ACA2-843F9689A5AF","sitecore_item_name":"A-population-based-study-to-evaluate-the-effectiveness-of-multi-disciplinary-heart-failure-clinics","sitecore_field_values":"{\n  \"Title\": \"A population-based study to evaluate the effectiveness of multi-disciplinary heart failure clinics and identify important service components\",\n  \"Short title\": \"A population-based study to evaluate\",\n  \"Citation\": \"<p>Wijeysundera HC, Trubiani G, Wang X, Mitsakakis N, Austin PC, Ko DT, Lee DS, Tu JV, Krahn M. <em>Circ Heart Fail<\/em>. 2013; 6(1):68-75. Epub 2012 Dec 10.<\/p>\",\n  \"Abstract\": \"<p><strong>Background<\/strong> &mdash; Multi-disciplinary heart failure (HF) clinics are efficacious in clinical trials. The researchers&rsquo; objectives were to compare real-world outcomes of HF patients treated in HF clinics vs. usual therapy and identify HF clinic features associated with improved outcomes.<\/p>n<p><span class=\"bold\">Methods and Results<\/span> &mdash; The service components at all HF clinics in Ontario, Canada were quantified using a validated instrument and categorized as high\/medium\/low intensity. The researchers used propensity scores to match HF clinic and control patients discharged alive after a HF readmission in 2006-07. Outcomes were mortality, and both all-cause and HF readmission. Cox-proportional hazard models were used to evaluate HF clinic level characteristics associated with improved outcomes. The researchers identified 14,468 HF patients, of whom 1,288 were seen in HF clinics. With 4 years of follow-up, 52.1% of HF clinic patients died versus 54.7% of control patients (p-value 0.02). HF clinic patients had increased readmissions (87.4% vs. 86.6% for all-cause [p-value 0.009]; 58.7% vs. 47.3% for HF-related [p-value &lt;0.001]). There was no difference between high, medium or low intensity clinics in terms of mortality, all-cause or HF readmissions. HF Clinics with greater frequency of visits (&gt; 4 contacts of significant duration over 6 months) were associated with lower mortality (HR 0.14; p-value &lt;0.0001) and hospitalization (HR 0.69; p-value 0.039). More intensive medication management was associated with lower all-cause (HR 0.46; p-value &lt;0.001) and HF readmission (HR 0.42; p-value &lt;0.001).<\/p>n<p><strong>Conclusions<\/strong> &mdash; In this real-world population based study, the researchers found that multi-disciplinary HF clinics are associated with a decrease in mortality but increase in readmissions.<\/p>n<p><a href=\"http:\/\/circheartfailure.ahajournals.org\/content\/6\/1\/68.full.pdf+html\" title=\"Full text\">View full text<\/a><\/p>\",\n  \"Keywords\": \"{C7AB16E8-F5E9-4F65-B290-CCDD28216A0A}|{92E2791D-5DAB-4244-8A85-434D524D9A12}|{A39C5396-16B7-4369-B0F9-31F6E91E46FC}\",\n  \"Related Products\": \"<h2>News Release<\/h2>rn<h3><a href=\"~\/link.aspx?_id=B8415A47CF224033A9DC672DDDB49136&amp;_z=z\">New study examines effectiveness of heart failure clinics<\/a><\/h3>\",\n  \"Research Programs\": \"{BEC72DE0-BA8C-42B8-ACE5-EE29FFB2CB3B}|{CFE36C89-C969-4C23-B5E4-1BA9E5BDC273}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}|{FBE2D1B1-C0BA-423F-8D16-39466B6C1424}\",\n  \"ICES Scientists\": \"{8C2597F4-2B41-4E87-9F28-6887C689651B}|{7D498E8B-5801-4F9E-AC41-11ED50F3C34E}|{B3827152-93D1-4FB2-B106-590CB331A264}|{CEEE13AD-C7DE-455F-ACF8-AAD7D27BB178}|{956599EC-5699-41D3-9375-E0B6C25B12D5}|{9EB22F72-67F1-409E-AB1B-D1C045367A84}\",\n  \"Posted Date\": \"20121210T000000\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2012\/January\/A-population-based-study-to-evaluate-the-effectiveness-of-multi-disciplinary-heart-failure-clinics"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | A population-based study to evaluate the effectiveness of multi-disciplinary heart failure clinics and identify important service components<\/title>\n<meta name=\"description\" content=\"Background &#x2014; Multi-disciplinary heart failure (HF) clinics are efficacious in clinical trials. 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