Abstract:
BACKGROUND:Little data exist to assist to help those organizing and managing heart failure (HF) disease management (DM) programs. We aimed to describe the intensity of outpatient HF care (clinic visits and telephone calls) and medical and nonpharmacological interventions in the outpatient setting. METHODS:This was a prospective substudy of 130 patients enrolled in STARBRITE in HFDM programs at 3 centers. Follow-up occurred 10, 30, 60, 90, and 120 days after discharge. The number of clinic visits and calls made by HF cardiologists, nurse practitioners, and nurses were prospectively tracked. The results were reported as medians and interquartile ranges. RESULTS:There were a total of 581 calls with 4 (2, 6) per patient and 467 clinic visits with 3 (2, 5) per patient. Time spent per patient was 8.9 (6, 10.6) minutes per call and 23.8 (20, 28.3) minutes per clinic visit. Nurses and nurse practitioners spent 113 hours delivering care on the phone, and physicians and nurse practitioners spent 187.6 hours in clinic. Issues addressed during calls included HF education (341 times [52.6%]) and fluid overload (87 times [41.8%]). Medical interventions included adjustments to loop diuretics (calls 101 times, clinic 156 times); beta-blockers (calls 18 times, clinic 126 times); vasodilators (calls 8 times, clinic 55 times). CONCLUSIONS:More than a third of clinician time was spent on calls, during which >50% of patient contacts and HF education and >39% of diuretic adjustments occurred. Administrators and public and private insurers need to recognize the amount of medical care delivered over the telephone and should consider reimbursement for these activities.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Shah MR,Whellan DJ,Peterson ED,Nohria A,Hasselblad V,Xue Z,Bowers MT,O'Connor CM,Califf RM,Stevenson LWdoi
10.1016/j.ahj.2007.12.026subject
Has Abstractpub_date
2008-04-01 00:00:00pages
764.e1-5issue
4eissn
0002-8703issn
1097-6744pii
S0002-8703(08)00005-7journal_volume
155pub_type
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journal_title:American heart journal
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2007-04-01 00:00:00
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更新日期:1988-08-01 00:00:00
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pub_type: 临床试验,杂志文章,多中心研究
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更新日期:2011-10-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:1995-08-01 00:00:00
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更新日期:2020-10-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/0002-8703(94)90740-4
更新日期:1994-12-01 00:00:00
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更新日期:1981-01-01 00:00:00
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更新日期:2004-12-01 00:00:00
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更新日期:1991-08-01 00:00:00
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更新日期:2001-05-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2007-04-01 00:00:00
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更新日期:1993-09-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2018-11-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Heart failure (HF) remains a major public health issue. Data on long-term trends in the incidence of HF and survival after its onset are limited. METHODS:A prospective cohort study conducted between 1985 and 2004 in 21,906 participants of the Physicians' Health Study I who were alive and free of HF on Janua...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.07.004
更新日期:2007-11-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:1979-11-01 00:00:00
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pub_type: 杂志文章
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更新日期:2011-04-01 00:00:00