Objective: To test the efficacy of intensive clinic follow-up for outpatients with chronic heart failure (CHF) on outcome.
Methods: All patients diagnosed as CHF in our cardiac center between January 2007 to December 2008 were included in this study. The patients were divided into two intensive follow-up (IF) and usual care (UC) groups. Endpoints including death or rehospitalization, medication, the quality of life evaluated with Minnesota Living with Heart Failure Questionnaire (MLHFQ) and hospital costs were analyzed with the data collected through hospital records or by telephone and post survey.
Results: A total of 333 patients were enrolled (108 patients in IF group and 225 in UC group). The mean follow-up duration was 454 days for IF group and 484 days for UC group. Mortality and readmission rate (66.67% vs. 42.59%, P < 0.05) and mortality rate (14.35% vs. 1.85%, P < 0.05) were significantly higher in UC group than in IF group. The percentage of patients receiving ACEI/ARB (86.79% vs. 40.54%, P < 0.05) and beta-adrenergic receptor blocker (89.62% vs. 46.49%, P < 0.05) were higher in IF group than in the UC group. In addition, the percentage of patients receiving target dosage of drugs is also higher in IF group (ACEI/ARB17.92%, BB17.92%) than in UC group (ACEI/ARB8.65%, BB1.62%, P < 0.05, respectively). Furthermore, mean MLHFQ total score (30.7 vs. 37.7, P < 0.05) and hospital cost (3821.51 RMB less per patient in this period) were significantly lower in IF group than in UC group.
Conclusion: Intensive clinic follow-up for outpatients with CHF in HF clinic can improve evidence-based treatment, reduce the readmission and death rate, improve quality of life and save hospital cost.