Telephone calls ring up benefits for heart failure patients

Sep 14 2012

By Piriya Mahendra, medwireNews Reporter

Active follow-up of chronic heart failure (HF) patients with telephone calls may lead to reduced all-cause mortality 1 year after discharge, a review demonstrates.

The Cochrane systematic review, conducted by Stephanie Taylor (Department of Public Health Medicine, London, UK) and team showed that HF patients who received a case-management intervention consisting of intensive monitoring via telephone calls and home visits from a specialist nurse had a 34% reduced risk for all-cause mortality 1 year after being discharged.

However, case management intervention patients did not have a significantly reduced risk for all-cause mortality at 6 months.

Although the number of deaths from chronic HF or cardiovascular disease was not significantly decreased with case management type interventions, there was a 36% reduced chance of chronic HF-related readmissions at 6 months and a 53% reduced risk at the 12-month follow-up.

The impact of this intervention on all-cause hospital admission was not apparent at 6 months, but was at 12 months, at an odds ratio of 0.75.

The review included 25 trials and 5942 people. The other two types of intervention studied include chronic HF clinic interventions and multidisciplinary interventions.

There were nonsignificant reductions in all-cause mortality, chronic HF-related admissions, and all-cause readmissions with chronic HF clinic interventions involving follow-up in a specialist chronic HF clinic.

Mortality was not reduced in the two studies reviewed that analyzed multidisciplinary interventions, where a team of professionals bridges the gap between hospital admission and living at home. However, all-cause mortality was significantly decreased by 54% and chronic HF-related admissions by 55% in these patients.

"We weren't able to identify the optimal components of case-management interventions, but telephone follow up by a specialist nurse was a very common element," remarked Taylor in a press statement.

She said that given the number of people with chronic HF, there is a need for research that compares different approaches to follow-up. In particular, she says, studies are needed to compare interventions that last for only a few weeks after discharge, with ones that span much longer periods.

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