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What is the impact of systems of care for heart failure on patients diagnosed with heart failure: a systematic review

Driscoll, Andrea, Meagher, Sharon, Kennedy, Rhoda, Hay, Melanie, Banerji, Jayant, Campbell, Donald, Cox, Nicholas, Gascard, Debra, Hare, David, Page, Karen, Nadurata, Voltaire, Sanders, Rhonda and Patsamanis, Harry 2016, What is the impact of systems of care for heart failure on patients diagnosed with heart failure: a systematic review, BMC cardiovascular disorders, vol. 16, Article Number : 195, pp. 1-20, doi: 10.1186/s12872-016-0371-7.

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Title What is the impact of systems of care for heart failure on patients diagnosed with heart failure: a systematic review
Author(s) Driscoll, AndreaORCID iD for Driscoll, Andrea orcid.org/0000-0002-6837-0249
Meagher, Sharon
Kennedy, Rhoda
Hay, Melanie
Banerji, Jayant
Campbell, Donald
Cox, Nicholas
Gascard, Debra
Hare, David
Page, Karen
Nadurata, Voltaire
Sanders, Rhonda
Patsamanis, Harry
Journal name BMC cardiovascular disorders
Volume number 16
Season Article Number : 195
Start page 1
End page 20
Total pages 20
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2016-10-11
ISSN 1471-2261
Keyword(s) Heart failure
Hospital readmissions
Hospitalisations
Primary care
Systematic review
Systems of care
Transitional care
Workforce
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
QUALITY-OF-CARE
EUROBSERVATIONAL RESEARCH-PROGRAM
ESC-HF PILOT
DISEASE MANAGEMENT
MEDICARE BENEFICIARIES
CLINICAL-OUTCOMES
HIGH-RISK
GUIDELINES PROGRAM
Summary BACKGROUND: Hospital admissions for heart failure are predicted to rise substantially over the next decade placing increasing pressure on the health care system. There is an urgent need to redesign systems of care for heart failure to improve evidence-based practice and create seamless transitions through the continuum of care. The aim of the review was to examine systems of care for heart failure that reduce hospital readmissions and/or mortality.

METHOD: Electronic databases searched were: Ovid MEDLINE, EMBASE, CINAHL, grey literature, reviewed bibliographies and Cochrane Central Register of Controlled Trials for randomised controlled trials, non-randomised trials and cohort studies from 1(st) January 2008 to 4(th) August 2015. Inclusion criteria for studies were: English language, randomised controlled trials, non-randomised trials and cohort studies of systems of care for patients diagnosed with heart failure and aimed at reducing hospital readmissions and/or mortality. Three reviewer authors independently assessed articles for eligibility based on title and abstract and then full-text. Quality of evidence was assessed using Newcastle-Ottawa Scale for non-randomised trials and GRADE rating tool for randomised controlled trials.

RESULTS: We included 29 articles reporting on systems of care in the workforce, primary care, in-hospital, transitional care, outpatients and telemonitoring. Several studies found that access to a specialist heart failure team/service reduced hospital readmissions and mortality. In primary care, a collaborative model of care where the primary physician shared the care with a cardiologist, improved patient outcomes compared to a primary physician only. During hospitalisation, quality improvement programs improved the quality of inpatient care resulting in reduced hospital readmissions and mortality. In the transitional care phase, heart failure programs, nurse-led clinics, and early outpatient follow-up reduced hospital readmissions. There was a lack of evidence as to the efficacy of telemonitoring with many studies finding conflicting evidence.

CONCLUSION: Redesigning systems of care aimed at improving the translation of evidence into clinical practice and transitional care can potentially improve patient outcomes in a cohort of patients known for high readmission rates and mortality.
Language eng
DOI 10.1186/s12872-016-0371-7
Field of Research 111003 Clinical Nursing: Secondary (Acute Care)
1102 Cardiovascular Medicine And Haematology
Socio Economic Objective 920103 Cardiovascular System and Diseases
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30089239

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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.