2Department of Cardiology, Faculty of Medicine, Ege University; İzmir-Turkey
3Department of Cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Education and Traning Hospital; İstanbul-Turkey
4Department of Cardiology, Şanlıurfa Balıklıgöl Hospital; Urfa-Turkey
5Department of Cardiology, Faculty of Medicine, Kocaeli University; Kocaeli-Turkey
6Department of Cardiology, Faculty of Medicine, Uludag University; Bursa-Turkey
7Department of Cardiology, Faculty of Medicine, Trakya University; Edirne-Turkey
8Department of Cardiology, Faculty of Medicine, Ondokuz Mayıs University; Samsun-Turkey
9Department of Cardiology, Faculty of Medicine, Gaziantep University; Gaziantep-Turkey
10Department of Cardiology, İzmir Atatürk Hospital; İzmir-Turkey
11Department of Cardiology, Ankara Yüksek İhtisas Hospital; Ankara-Turkey
12Department of Cardiology, Faculty of Medicine, University of Pittsburgh; Pittsburgh, PA-USA
Abstract
Objective: The aim of this study was to assess the efficacy and feasibility of an enhanced heart failure (HF) education with a 6-month telephone follow- up program in post-discharge ambulatory HF patients.
Materials and Methods: The Hit-Point trial was a multicenter, randomized, controlled trial of enhanced HF education with a 6-month telephone follow-up pro- gram (EHFP) vs routine care (RC) in patients with HF and reduced ejection fraction. A total of 248 patients from 10 centers in various geographical areas were randomized: 125 to EHFP and 123 to RC. Education included information on adherence to treatment, symptom recognition, diet and fluid intake, weight monitoring, activity and exercise training. Patients were contacted by telephone after 1, 3, and 6 months. The primary study endpoint was cardiovascular death.
Results: Although all-cause mortality didn’t differ between the EHFP and RC groups (p=NS), the percentage of cardiovascular deaths in the EHFP group was significantly lower than in the RC group at the 6-month follow up (5.6% vs. 8.9%, p=0.04). The median number of emergency room visits was one and the median number of all cause hospitalizations and heart failure hospitalizations were zero. Twenty-tree percent of the EHFP group and 35% of the RC group had more than a median number of emergency room visits (p=0.05). There was no significant difference regarding the median number of all–cause or heart failure hospitalizations. At baseline, 60% of patients in EHFP and 61% in RC were in NYHA Class III or IV, while at the 6-month follow up only 12% in EHFP and 32% in RC were in NYHA Class III or IV (p=0.001).
Conclusion: These results demonstrate the potential clinical benefits of an enhanced HF education and follow up program led by a cardiologist in reducing cardiovascular deaths and number of emergency room visits with an improvement in functional capacity at 6 months in post-discharge ambulatory HF patients. (Anatol J Cardiol 2017; 17: 107-12)