Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access
Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc
Journal website https://www.cardiologyres.org

Review

Volume 5, Number 5, October 2014, pages 126-138

Reducing Heart Failure Hospital Readmissions: A Systematic Review of Disease Management Programs

Tables

Table 1. Randomized Trials of Heart Failure Disease Management Programs Using Home Visits
 
ReferenceDuration of interventionDuration of follow-upNo. of control patientsNo. of intervention patientsPrimary outcomeResults
Primary outcomeACMACHHFH
ACM: all-cause mortality; ACH: all-cause hospitalization; HFH: heart failure hospitalization; 0: not significant; +: significant; NR: not reported.
Rich et al 1995 [12]3 months3 months14014290 days ACH-free survival00++
Jaarsma et al 1999 [13]1 visit9 months9584ACH0000
Blue et al 2001 [14]12 months12 months8184ACH plus HFH+00+
Harrison et al 2002 [15]2 weeks5 months10092QOL+000
Stewart and Horowitz 2002 [16]6 months6 months148149ACH plus ACM+000
Holland et al 2007 [17]6 months6 months144149ACH000NR
Jaarsma et al 2008 [18]18 months18 months348701ACM plus HFH0000

 

Table 2. Randomized Trials of Heart Failure Disease Management Programs Using Outpatient Visits
 
ReferenceDuration of interventionDuration of follow-upNo. of control patientsNo. of intervention patientsPrimary outcomeResults
Primary outcomeACMACHHFH
ACM: all-cause mortality; ACH: all-cause hospitalization; HFH: heart failure hospitalization; 0: not significant; +: significant; NR: not reported.
Cline et al 1998 [20]12 months12 months11080Time to readmission+00NR
Ekman et al 1998 [21]6 months6 months7979ACH plus ACM0000
Kasper et al 2002 [22]6 months6 months98102ACM plus HFH0000
Doughty et al 2002 [23]12 months12 months97100ACH plus ACM00+0
Ledwidge et al 2002 [24]3 months3 months4751Cost benefit+0++
Capomolla et al 2002 [25]12 months12 months122112Cost utility+++NR
Stromberg et al 2003 [26]12 months12 months5452ACM plus ACH+++0
de la Porte et al 2007 [27]12 months12 months122118ACM plus HFH+0++
Powell et al 2010 [28]12 months31 months451451ACM plus HFH0000

 

Table 3. Randomized Trials of Heart Failure Disease Management Programs Using Structured Telephone Support
 
ReferenceDuration of interventionDuration of follow-upNo. of control patientsNo. of intervention patientsPrimary outcomeResults
Primary outcomeACMACHHFH
ACM: all-cause mortality; ACH: all-cause hospitalization; HFH: heart failure hospitalization; 0: not significant; +: significant; NR: not reported.
Gattis et al 1999 [29]6 months6 months9190ACM plus HFH+0NR+
Riegel et al 2002 [30]6 months6 months228130HFH+00+
Krumholz et al 2002 [31]12 months12 months4444ACH plus ACM000+
Laramee et al 2003 [32]3 months3 months146141ACH0000
Tsuyuki et al 2004 [33]6 months6 months136140Medication adherence0000
DeBusk et al 2004 [34]12 months12 months234228Time to HFH0000
Galbreath et al 2004 [35]18 months18 months359710ACM++00
Cleland et al 2005 [36]8 months8 months85173ACM plus ACH0+00
GESICA Investigators 2005 [37]16 months16 months758760ACM plus HFH+00+
Riegel et al 2006 [38]6 months6 months6569ACH0000
Sisk et al 2006 [39]12 months12 months203203ACM plus ACH00+0
Mortara et al 2009 [40]12 months12 months160106Cardiac death plus HFH0000
DeWalt et al 2012 [41]12 months12 months302303ACH plus ACM0NRNR0

 

Table 4. Randomized Trials of Heart Failure Disease Management Programs Using Non-Invasive Telemonitoring
 
ReferenceDuration of interventionDuration at follow-upNo. of control patientsNo. of intervention patientsPrimary outcomeResults
Primary outcomeACMACHHFH
ACM: all-cause mortality; ACH: all cause hospitalization; HFH: heart failure hospitalization; CV: cardiovascular; 0: not significant; +: significant; NR: not reported; BNP: b-type naturetic peptide; QOL: quality of life.
Goldberg et al 2003 [43]6 months6 months142138ACH0+0NR
Capomolla et al 2004 [44]12 months10 months6667ACH plus ACM+0++
Cleland et al 2005 [36]8 months8 months85168ACH plus ACM0+00
Balk et al 2008 [45]9 months9 months113101ACH plus ACM000NR
Antonicelli et al 2008 [46]12 months12 months2928ACM plus ACH+0+NR
Soran et al 2008 [47]6 months6 months155160CV death plus HFH0000
Woodend et al 2008 [48]3 months12 months5962ACH0NR0NR
Dar et al 2009 [49]6 months6 months9191ACH plus ACM0NR00
Giordano et al 2009 [50]12 months12 months230230ACH plus CV mortalityNR0++
Mortara et al 2009 [40]12 months12 months160195CV death plus HFH0000
Weintraub et al 2010 [51]3 months3 months9395HFH+00+
Chaudhry et al 2010 [52]6 months6 months827826ACM plus ACH0000
Koehler et al 2011 [53]26 months26 months356354ACM0000
Seto et al 2012 [54]6 months6 months5050Changes in BNP/QOL+000

 

Table 5. Randomized Trials of Heart Failure Disease Management Programs Using Invasive Hemodynamic Monitoring
 
ReferenceType of hemodynamic monitoringDuration of interventionDuration of follow-upNo. of control patientsNo. of intervention patientsPrimary outcomeResults
Primary outcomeACMACHHFH
ACM: all-cause mortality; ACH: all-cause hospitalization; HFH: heart failure hospitalization; 0: not significant; +: significant; NR: not reported; ED: emergency department; OPV: outpatient visits.
Van Veldhuisen et al 2011 [58]Intrathoracic impedance14.5 months14.5 months167168ACM plus HFH0000
Crossley et al 2011 [62]Intrathoracic Impedance15 months15 months9831014Time to clinical decision+000
Landolina et al 2012 [63]Intrathoracic impedance16 months16 months10199ED and urgent OPV+NR00
Abraham et al 2011 [64]Pulmonary artery pressures15 months15 months270280HFH+00+
Bourge et al 2008 [66]Right ventricular pressures6 months6 months140134HF-related urgent events0NRNR0
Adamson et al 2011 [67]Right ventricular pressures12 months12 months198202HF-related urgent events0NR00

 

Table 6. HFSA Recommended Elements of Heart Failure Disease Management Programs [69]
 
HFSA: Heart Failure Society of America.
1Comprehensive education and counseling individualized to the patient and patients’ environment
2Promotion of self-care behaviors including potentially self-titration of diuretic dosing (with family member/healthcare provider assistance)
3Emphasis on behavioral strategies to ensure adequate compliance
4Adequate follow-up after hospital discharge or clinical instability (preferably within the first 7 days after event)
5Optimization of oral therapy especially evidence-based therapy
6Increased access to healthcare providers
7Early attention to signs and symptoms of fluid overload
8Assistance with financial and social concerns