Feasibility and effectiveness of a multidimensional post-discharge disease management programme for heart failure patients in clinical practice: the HerzMobil Tirol programme

Aims It remains unclear whether transitional care management outside of a clinical trial setting provides benefits for patients with acute heart failure (AHF) after hospitalization. We evaluated the feasibility and effectiveness of a multidimensional post-discharge disease management programme using...

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Bibliographic Details
Published in:Clinical research in cardiology 2022-03, Vol.111 (3), p.294-307
Main Authors: Poelzl, G., Egelseer-Bruendl, T., Pfeifer, B., Modre-Osprian, R., Welte, S., Fetz, B., Krestan, S., Haselwanter, B., Zaruba, M. M., Doerler, J., Rissbacher, C., Ammenwerth, E., Bauer, A.
Format: Article
Language:English
Subjects:
Aftercare - methods
Aged
Cardiology
Clinical medicine
Congestive heart failure
Coronary artery disease
Disease Management
Feasibility Studies
Female
Heart failure
Heart Failure - rehabilitation
Humans
Male
Medical personnel
Medicine
Medicine & Public Health
Middle Aged
Monitoring
Monitoring systems
Monitoring, Physiologic
Nurses
Original Paper
Patient Readmission - statistics & numerical data
Patients
Physicians
Program Evaluation
Proportional Hazards Models
Retrospective Studies
Statistical models
Subgroups
Telemedicine
Telemedicine - methods
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Summary:Aims It remains unclear whether transitional care management outside of a clinical trial setting provides benefits for patients with acute heart failure (AHF) after hospitalization. We evaluated the feasibility and effectiveness of a multidimensional post-discharge disease management programme using a telemedical monitoring system incorporated in a comprehensive network of heart failure nurses, resident physicians, and secondary and tertiary referral centres (HerzMobil Tirol, HMT), Methods and results The non-randomized study included 508 AHF patients that were managed in HMT ( n  = 251) or contemporaneously in usual care (UC, n  = 257) after discharge from hospital from 2016 to 2019. Groups were retrospectively matched for age and sex. The primary endpoint was time to HF readmission and all-cause mortality within 6 months. Multivariable Cox proportional hazard models were used to assess the effectiveness. The primary endpoint occurred in 48 patients (19.1%) in HMT and 89 (34.6%) in UC. Compared with UC, management by HMT was associated with a 46%-reduction in the primary endpoint (adjusted HR 0.54; 95% CI 0.37–0.77; P  
ISSN:1861-0684
1861-0692
DOI:10.1007/s00392-021-01912-0