The Impact of Addressing Adherence in Pharmacist-Managed Pharmacotherapy Clinics

2016 ◽  
Vol 30 (1) ◽  
pp. 37-41 ◽  
Author(s):  
Nora H. Sharaya ◽  
Megan F. Dorrell ◽  
Nick A. Sciacca
Keyword(s):  
Standard Of Care ◽  
Pharmacist Intervention ◽  
Primary Objective ◽  
Primary Care Clinics ◽  
Medication Therapy ◽  
Adherence To Medication ◽  
Medication Information ◽  
Secondary Objective ◽  
The Impact

Purpose: The primary objective of this study was to determine the change in the adherence questionnaire score from the initial pharmacist intervention to 60 to 90 days follow-up. The secondary objective of this study was to investigate the impact of the type of pharmacist intervention on questionnaire scores. Methods: Administration of an adherence questionnaire to guide interventions has become the standard of care for patients during appointments with clinical pharmacy specialists at 3 primary care clinics. Subjects who received a questionnaire between November 4, 2013, and January 15, 2014, were included. These subjects received a second questionnaire 60 to 90 days after the first questionnaire to identify changes resulting from the pharmacist’s interventions. A scoring system was utilized to quantify patients’ responses to both the preintervention and postintervention questionnaires. The type of intervention completed was determined at each pharmacist’s clinical discretion. Results: Adherence scores increased significantly 60 to 90 days after administration of the questionnaire with a pharmacist’s intervention. Medication reminders, simplifying medication regimens, discount program referrals, disease-state information, medication information, and therapeutic interchanges, all increased adherence scores. Conclusion: A standardized tool to assess and address adherence was effectively utilized by 9 pharmacists at 3 clinics. The use of a standardized tool to guide adherence interventions is an effective way to increase adherence to medication therapy.

Abstract 3729: Delayed Hematoma Expansion Occurs After ICH: Observations from the Safety of Pioglitazone for Hematoma Resolution in INtraCerebral Hemorrhage (SHRINC) trial

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Navdeep S Sangha ◽  
Farhaan Vahidy ◽  
Mallikarjunarao Kasam ◽  
Mohammed Rahbar ◽  
Bursaw Andrew ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Prospective Study ◽  
Univariate Analysis ◽  
Primary Objective ◽  
Hematoma Expansion ◽  
Hematoma Growth ◽  
Secondary Objective ◽  
Magnetic Resonance Imaging Mri ◽  
Associated Risk Factors

Background and Purpose Early hematoma expansion (EHE) has been described in the first 48 hours. SHRINC is a phase 2 prospective safety trial whose primary objective is to assess the safety of pioglitazone (PIO) when administered to patients with spontaneous intracerebral hemorrhage (SICH) compared to standard care. A secondary objective is to characterize the changes in hematoma resolution and expansion over time. This prospective study addresses the natural history, clinical impact, and associated risk factors of late hematoma expansion (LEX) by serial magnetic resonance imaging (MRI) after SICH. Methods SHRINC aims to enroll 78 subjects between the ages of 18-80 with a SICH of ≥ 5 ml. This analysis includes the first 42 patients enrolled. Four subjects were excluded because they did not have an MRI after day 2. A baseline CTH was performed followed by an MRI within 24 hours of symptom onset. Hematoma volume (Hv) was measured on FLAIR sequences using a previously published semi-automated range of interest method. LEX was defined as an increase in Hv > 0.5 ml after the 48 hour MRI. Factors associated with LEX were evaluated with logistic regression. Longitudinal analyses were used for measurements taken over the follow up period. Results: Ten (26.3%) of 38 subjects displayed LEX. Eight subjects had LEX between day 2 to 14, and 4 between days 14 to 28. The median initial Hv was 16.1cc in LEX patients and 24.1cc in those without expansion (NEX) (p=0.23). Lower platelet counts (p=0.04) and BUN levels (p=0.03) were associated with LEX in univariate analysis. Multivariate analysis suggested that those with higher BUN levels were less likely to have LEX (OR=0.81; 95%CI 0.65-0.99). Blood pressure and EHE (13.2%) were not associated with LEX. There was no difference in neurological worsening (NIHSS increase ≥ 4), 6 month mRS or death between LEX and NEX. Conclusion: This is the first prospective study to address LEX with serial MRIs. LEX occurs between day 2 to 14 and day 14 to 28. Elevated BUN levels may decrease the likelihood of LEX. A limitation of our study is that the effect of PIO on LEX could not be evaluated because SHRINC is a blinded trial. Further studies will assess the pathophysiology of LEX and its potential implications in clinical trials evaluating hematoma growth and resolution.

A Critical Analysis of the Specific Pharmacist Interventions and Risk Assessments During the 12-Month TRANSAFE Rx Randomized Controlled Trial

2021 ◽  
pp. 106002802110447
Author(s):  
Haley M. Gonzales ◽  
James N. Fleming ◽  
Mulugeta Gebregziabher ◽  
Maria Aurora Posadas Salas ◽  
John W. McGillicuddy ◽  
...  
Keyword(s):  
High Risk ◽  
Medication Reconciliation ◽  
Controlled Trial ◽  
Therapy Monitoring ◽  
Pharmacist Intervention ◽  
Risk Levels ◽  
Medication Therapy ◽  
Risk Patients ◽  
The Impact ◽  
Medication Changes

Background Medication safety issues have detrimental implications on long-term outcomes in the high-risk kidney transplant (KTX) population. Medication errors, adverse drug events, and medication nonadherence are important and modifiable mechanisms of graft loss. Objective To describe the frequency and types of interventions made during a pharmacist-led, mobile health–based intervention in KTX recipients and the impact on patient risk levels. Methods This was a secondary analysis of data collected during a 12-month, parallel-arm, 1:1 randomized clinical controlled trial including 136 KTX recipients. Participants were randomized to receive either usual care or supplemental, pharmacist-driven medication therapy monitoring and management using a smartphone-enabled app integrated with telemonitoring of blood pressure and glucose (when applicable) and risk-based televisits. The primary outcome was pharmacist intervention type. Secondary outcomes included frequency of interventions and changes in risk levels. Results A total of 68 patients were randomized to the intervention and included in this analysis. The mean age at baseline was 50.2 years; 51.5% of participants were male, and 58.8% were black. Primary pharmacist intervention types were medication reconciliation and patient education, followed by medication changes. Medication reconciliation remained high throughout the study period, whereas education and medication changes trended downward. From baseline to month 12, we observed an approximately 15% decrease in high-risk patients and a corresponding 15% increase in medium- or low-risk patients. Conclusion and Relevance A pharmacist-led mHealth intervention may enhance opportunities for pharmacological and nonpharmacological interventions and mitigate risk levels in KTX recipients.

scholarly journals 90. Impact of Discrepant Rapid Diagnostic Test (RDT) Results on Antimicrobial Stewardship Program (ASP) Interventions in Patients with Bloodstream Infections (BSI) due to Gram-Negative Bacilli (GNB)

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S61-S61
Author(s):  
Evan D Robinson ◽  
Heather L Cox ◽  
April E Attai ◽  
Lindsay Donohue ◽  
Megan Shah ◽  
...  
Keyword(s):  
Susceptibility Testing ◽  
Bloodstream Infections ◽  
Standard Of Care ◽  
First Year ◽  
Beta Lactam ◽  
Gram Negative ◽  
Stewardship Program ◽  
Few Data ◽  
The Impact

Abstract Background Implementation of the Accelerate PhenoTM Gram-negative platform (AXDX) paired with ASP intervention projects to improve time to definitive institutional-preferred antimicrobial therapy (IPT). However, few data describe the impact of discrepant RDT results from standard of care (SOC) methods on antimicrobial prescribing. Here we evaluate the prescribing outcomes for discrepant results following the first year of AXDX + ASP implementation. Methods Consecutive, non-duplicate blood cultures for adult inpatients with GNB BSI following combined RDT + ASP intervention were included (July 2018 – July 2019). AXDX results were emailed to the ASP in real time then released into the EMR upon ASP review and communication with the treating team. SOC identification (ID; Vitek® MS/Vitek® 2) and antimicrobial susceptibility testing (AST; Trek SensititreTM) followed RDT as the reference standard. IPT was defined as the narrowest susceptible beta-lactam, and a discrepancy was characterized when there was categorical disagreement between RDT and SOC methods. When IPT by AXDX was found to be non-susceptible on SOC, this was characterized as “false susceptible“. Conversely, “false resistance” was assessed when a narrower-spectrum agent was susceptible by SOC. Results were also deemed discrepant when the AXDX provided no/incorrect ID for on-panel organisms, no AST, or a polymicrobial specimen was missed. Results Sixty-nine of 250 patients (28%) had a discrepancy in organism ID or AST: false resistance (9%), false susceptible (5%), no AST (5%), no ID (4%), incorrect ID (2%), and missed polymicrobial (2%). A prescribing impact occurred in 55% of cases (Table 1), where unnecessarily broad therapy was continued most often. Erroneous escalation (7%) and de-escalation to inactive therapy (7%) occurred less frequently. In-hospital mortality occurred in 4 cases, none of which followed an inappropriate transition to inactive therapy. Conclusion Though the AXDX platform provides rapid ID and AST results, close coordination with Clinical Microbiology and continued ASP follow up are needed to optimize therapy. Although uncommon, the potential for erroneous ASP recommendations to de-escalate to inactive therapy following AXDX results warrants further investigation. Disclosures Amy J. Mathers, MD, D(ABMM), Accelerate Diagnostics (Consultant)

scholarly journals A Multi-Objective Approach to Mitigate Negative Side Effects

2020 ◽  
Author(s):  
Sandhya Saisubramanian ◽  
Ece Kamar ◽  
Shlomo Zilberstein
Keyword(s):  
Side Effects ◽  
Empirical Evaluation ◽  
Primary Objective ◽  
Maximum Deviation ◽  
Negative Side ◽  
Multi Objective ◽  
Markov Decision ◽  
Secondary Objective ◽  
Negative Side Effects ◽  
The Impact

Agents operating in unstructured environments often create negative side effects (NSE) that may not be easy to identify at design time. We examine how various forms of human feedback or autonomous exploration can be used to learn a penalty function associated with NSE during system deployment. We formulate the problem of mitigating the impact of NSE as a multi-objective Markov decision process with lexicographic reward preferences and slack. The slack denotes the maximum deviation from an optimal policy with respect to the agent's primary objective allowed in order to mitigate NSE as a secondary objective. Empirical evaluation of our approach shows that the proposed framework can successfully mitigate NSE and that different feedback mechanisms introduce different biases, which influence the identification of NSE.

Effective Pharmacist led interventional strategies to improve outcomes in hypertensive patients: a narrative review

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Samra Bashir ◽  
Akash Syed
Keyword(s):  
Pharmaceutical Care ◽  
Cost Effective ◽  
Pharmacist Intervention ◽  
Care Plan ◽  
Hypertensive Patients ◽  
Disease Outcomes ◽  
Cost Effective Alternative ◽  
The Impact

The role of pharmacist intervention as a cost-effective alternative to physician in disease management is increasingly been recognized. Studies have demonstrated that pharmaceutical care can improve drug therapy as well as patient satisfaction in chronic health conditions including cardiovascular diseases. This study is aimed to review and outline a comprehensive pharmaceutical care plan from the randomized controlled trials previously conducted to assess the impact of pharmacist-managed care on disease outcomes in hypertensive patients. Compared with usual care, the pharmaceutical intervention involved patient evaluation, patient education and counselling, medication review and management, patient monitoring and follow-up, and feedback to the primary physician as major strategies.

BPI19-016: Evaluation of the Use of a Single Dose Rasburicase in Prophylaxis and Management of Tumor Lysis Syndrome (TLS) Among Cancer Patients in Qatar

2019 ◽  
Vol 17 (3.5) ◽  
pp. BPI19-016
Author(s):  
Nancy Kassem ◽  
Halima El Omri ◽  
Mohamed Yassin ◽  
Shereen Elazzazy
Keyword(s):  
Single Dose ◽  
Tumor Lysis Syndrome ◽  
Lactate Dehydrogenase Level ◽  
Primary Objective ◽  
Urate Oxidase ◽  
Multiple Doses ◽  
Oxidase Enzyme ◽  
Secondary Objective ◽  
Significant Cost Reduction ◽  
The Impact

Introduction: Rasburicase is a urate oxidase enzyme used for prophylaxis and treatment of hyperuricemia associated with TLS. The recommended dose of rasburicase is 0.2 mg/kg/day for 5 days; however, recent studies have demonstrated the effectiveness of a single rasburicase dose in prophylaxis and management of hyperuricemia associated with TLS. Our institution’s TLS guideline was updated to recommend the use of a single rasburicase dose (0.2 mg/kg). The primary objective of this study was to assess the efficacy of a single rasburicase dose in controlling uric acid (UA); the secondary objective was to evaluate the impact of the institutional TLS guidelines update on consumption and cost of rasburicase. Methods: This is a single center retrospective cohort study including all patients who received rasburicase from August 2012 to March 2016 at the National Center for Cancer Care and Research (NCCCR) in Qatar. Patients were divided into 2 groups based on the prescribed number of rasburicase doses (single dose vs multiple doses). Collected data included patients’ diagnosis, laboratory parameters rasburicase dose, duration, and number of dispensed vials. UA levels within 24 hours and on day 5 of initial rasburicase dose were evaluated. Risk stratification was determined according to institutional guidelines based on disease, white blood cell count, lactate dehydrogenase level, renal function, and UA level. Results: A total of 103 patients who received rasburicase were evaluated retrospectively; rasburicase was prescribed as single dose for 65 patients (63%) and multiple doses for 38 patients (37%). The majority of patients who received rasburicase as single or multiple doses were at high risk of developing TLS, representing 68% and 84%, respectively. Baseline mean UA levels were similar in both groups: 5.4±2.9 mg/dL vs 4.7±3.2 mg/L respectively (P=.7). Normal or undetectable UA levels were observed within 24 hours in 98% of patients in the single dose group and 100% of patients in the multiple doses group. All patients in both groups had normal UA on day 5 of rasburicase with relatively similar UA levels: 1.5±1.2 mg/dL vs 0.8±1 mg/dL (P=.18). Rasburicase consumption and cost were reduced by 42.5% after the guidelines update. Conclusion: The single rasburicase dose demonstrated efficacy in controlling serum UA levels. Updating the institutional TLS guidelines had a significant impact on rasburicase consumption and led to significant cost reduction.

Autologous Hematopoietic Stem Cell Transplantation (autoHSCT) in CLL: First Results of An EBMT Randomized Trial Comparing Autotransplant Versus Wait and Watch.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 877-877
Author(s):  
Mauricette Michallet ◽  
Peter Dreger ◽  
Laurent Sutton ◽  
Ronald Brand ◽  
Sue Richards ◽  
...  
Keyword(s):  
Conflicts Of Interest ◽  
Progression Free Survival ◽  
Disease Status ◽  
Primary Objective ◽  
Phase Iii ◽  
Induction Treatment ◽  
Hematopoietic Stem ◽  
Binet Stage ◽  
The Impact

Abstract Abstract 877 This phase-III randomized EBMT-intergroup trial studied the impact of a consolidating autoHSCT vs no consolidation for patients with CLL in Binet stage A progressive, B or C , in CR, nodular PR or VGPR after first or second line therapy. The primary objective was to show that autoHSCT increased the 5-year progression-free survival (PFS) by 30%. Although it had been calculated that 270 patients were to be randomized, the study was terminated by the steering committee in July 2007 due to poor accrual. Here we present a first analysis based on 69% of expected follow-up forms. Results: Between November 2001 and July 2007, 223 patients were enrolled (SFGM-TC/FCLLG n=98, MRC n=62, GCLLSG n=32, SAKK n=10, other EBMT centers n=17). There were 74% males and 26% females. Binet stages were progressive A 13%, B 67%, C 20%; 59% were in CR, and 41% in very good or nodular PR. Of note, SFGM-TC/FCLLG included only patients in CR. 82% of the patients were enrolled in 1st, and 18% in 2nd remission. Patients were randomized between group 1 (autoHSCT n=112) and group 2 (observation n=111) after an induction treatment which was left at the discretion of the investigators. Median PFS was 43 months in the observation group but not reached in the autoHSCT group; 5-year PFS was 48% and 65%, respectively (p=0.005). Accordingly, autoHSCT halved the relapse risk (5-year relapse incidence 25% vs. 51%; HR 0.4 [0.23-0.71], p=0.002). Cox modeling for randomization arm, Binet stage, disease status, line of treatment, contributing group (country), and the interaction between randomization arm and contributing group confirmed that autoHSCT significantly improved PFS (HR 0.41 [0.23-0.75] p=0.004). The beneficial effect of autoHSCT was stable over all contributing groups although patients accrued by SFGM-TC/FCLLG overall had a significantly better PFS than patients from other countries (HR 0.2 [0.08-0.55], p=0.001). At 5 years, the probability of OS was 92% and 91% for autoHSCT and observation, respectively. Significant differences in terms of non-relapse death were not observed. At the last follow up, among 205 evaluable patients, 186 are alive (147CR, 39 relapse), 19 died (14 from relapse and 5 from non-relapse causes) . In conclusion, in patients with CLL in first or second remission, consolidating autoHSCT reduces the risk of progression (PFS) by more than 50%, but has no effect on overall survival. Disclosures: No relevant conflicts of interest to declare.

Influence of the localization of the primary tumor in the survival of patients with metastatic colon-rectal cancer treated with bevacizumab.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 665-665
Author(s):  
Inmaculada Gallego Jimenez ◽  
Amelia Lopez Ladron ◽  
David Morales Pancorbo ◽  
Eva Fernandez Parra ◽  
Maria Rodriguez de la Borbolla ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Primary Tumor ◽  
Tertiary Care ◽  
Standard Of Care ◽  
Left Colon ◽  
Care Hospital ◽  
First Line Therapy ◽  
Colon Rectal Cancer ◽  
The Impact

665 Background: Bevacizumab, a humanized antibody against the molecular target endotelial growth factor VEGF-A, has incorporated to the standard of care of metastatic colon-rectal cancer (mCRC). A recent study has suggested that the left colon localization of the primary tumor may be a factor associated with a poorer survival in individuals treated against mCRC with bevacizumab including chemotherapy. Our objective was to analyze the impact of the localization of the primary tumor on the survival of patients with mCRC treated with bevacizumab. Methods: Prospective cohort study conducted in a tertiary-care hospital in Spain. Twenty-nine consecutive patients with mCRC who started a first-line therapy including bevacizumab were included. Patients were followed up until death, lost to follow-up or the censoring date (31th August, 2013). The primary end-point of the study was death from any cause. Predictors of survival, including the localization of the primary tumor, were assessed. Results: The median (Q1-Q3) age was 59 (52-67) years and 13 (45%) patients were male. Chemotherapy scheme was XELOX in 13 (45%) patients, FOLFOX in 8 (28%), FOLFIRI in 5 (17%), XELIRI in 2 (7%) and capecitabine in 1 (3%) patient. The localization of the primary tumor were distributed as follows: rectum in 6 (21%), sigmoid colon in 9 (31%), left colon in 9 (31%) and right colon in 5 (17%) patients. After a median (Q1-Q3) follow-up of 29 (13-41) months, 19 (66%) patients died. There were no patients lost to the follow-up. The mean (SD) survival in patients with left colon cancer was 25 (8) months whereas it was 47 (7) months in the remaining population (p = 0.1). The low sample size precluded to perform reliable multivariate analyses. Conclusions: Our study suggests that left colon localization of the primary tumor may have a worse prognosis in patients with mCRC treated with bevacizumab. Although no statistically significant differences have been observed, this fact may have been a consequence of the limited power of the analysed sample. Collaborative studies should be perfomed in order to clarify this issue.

Impact of cetuximab sequence on progress-free survival (PFS) and overall survival (OS) in patients with RAS wild-type metastatic colorectal cancer (mCRC): A real-world study.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16042-e16042
Author(s):  
Qirong Geng ◽  
Wenxiu Cheng ◽  
Zhiyu Chen ◽  
Wen Zhang ◽  
Xiaodong Zhu ◽  
...  
Keyword(s):  
Real World ◽  
Primary Tumour ◽  
Primary Objective ◽  
Wild Type ◽  
Line Therapy ◽  
Investigation Methods ◽  
Secondary Objective ◽  
Line Of Therapy ◽  
Metastatic Sites ◽  
The Impact

e16042 Background: Cetuximab provides a clear clinical benefit in the treatment in patients with RAS wild-type mCRC irrespective of treatment line, but the best sequence is still under investigation. Methods: Patients with RAS wild-type mCRC (2011-2019) who received cetuximab therapy were retrospectively analyzed. They were stratified based on the cetuximab treatment sequence, into the 1st, 2nd, 3rd or later-lines groups. The primary objective was to investigate the impact on Cetuximab sequence (2nd vs. 3rd and later-line) in PFS and OS. As for patients received the 3rd or later-line cetuximab with irinotecan therapy after refractory to the prior 1st and 2nd-line combined chemotherapy with fluoropyrimidine, oxaliplatin, and irinotecan, they will get another PFS of 2nd-line chemotherapy (PFSchemo) besides the PFS of 3rd or later-line cetuximab compared with the cetuximab 2nd-line used patients. We combined the PFSchemo to the PFS of 3rd or later-line cetuximab, then compared with PFS of 2nd -line cetuximab to evaluate the primary objective in PFS. As for the OS of primary objective, we calculated it from start of the 2nd-line of treatment. The secondary objective was to compare the efficacy of cetuximab sequence (1st vs. 2nd and later-lines) in OS calculated from start of the 1st-line of treatment. Results: In total, 193 patients were included: 106 in the 1st, 41 in the 2nd, and 46 in the 3rd-line groups. No difference was observed in baseline characteristics as sex,age,site of primary tumour,number of metastatic sites in the three groups. The median PFS of the 2nd-line and 3rd or later-line groups were 7.1 (95% CI 6.39-7.80) and 13.87 months(95% CI 11.44-16.29) respectively. PFS of the 3rd or later-line group was significantly longer than that of the 2nd-line group (hazard ratio[HR], 0.552; 95% CI, 0.349 to 0.871; P = 0.01). Median OS was 17.8 months (95% CI 13.5-22.1) in the 2nd-line and 27.4 months (95% CI 20.69-34.16) in the 3rd or later-line group (HR, 0.597; 95% CI 0.341 to 1.043; P = 0.07) from start of 2nd-line therapy. The median OS was 28.17 months (95% CI 22.11-34.22) in the 1st-line group and 33.10 months (95% CI 26.88-39.31) in the 2nd and later-lines group (HR, 0.724; 95% CI 0.507 to 1.304; P = 0.075) calculated from the 1st-line of therapy. Conclusions: In a real-world cohort we found that later-line especially 3rd or later-line therapy of cetuximab, may be more benefit for patients with RAS wild type mCRC, as 3rd or later-line use of cetuximab give one more line therapy chance.

scholarly journals Biomarkers-based Personalized Follow-up in Chronic Heart Failure Improves Patient’s Outcomes and Reduces Care Associate Cost

2020 ◽  
Author(s):  
Antonio Leon Justel ◽  
Jose Ignacio Morgado Garcia-Polavieja ◽  
Ana Isabel Alvarez Rios ◽  
Francisco Jose Caro Fernandez ◽  
Pedro Agustin Pajaro Merino ◽  
...  
Keyword(s):  
Incidence Rates ◽  
Primary Objective ◽  
Economic Problem ◽  
Functional Class ◽  
Post Intervention ◽  
Number Of Patients ◽  
Before And After ◽  
Ed Visits ◽  
The Impact

Abstract BACKGROUNDHeart failure (HF) is a major and growing medical and economic problem, with high prevalence and incidence rates worldwide. Cardiac Biomarker is emerging as a novel tool for improving management of patients with HF.METHODSThis is a real-world, before-and after-intervention trial, that assesses the impact of a personalized follow-up procedure for HF on patient’s outcomes and care associated cost, based on a clinical model of risk stratification and personalized management according to that risk. A total of 192 patients were enrolled and studied before and after an intervention. The primary objective was the rate of readmissions, due to a HF event, post-intervention compared to pre-intervention. Secondary outcomes compared the rate of ED visits and the number of patients who had reduced NYHA score pre and post-intervention. A cost- analysis was also performed on these data.RESULTSAdmission rates significantly decreased by 41% after the intervention (total length of stay was reduced by 55%). The rate of ED visits was reduced by 55%. Thirty-one percent of patients had an improved functional class score after the intervention, whereas only 7.8% got worse. The overall cost saving associated with the intervention was €139,717.65 for the whole group over 1 year.CONCLUSIONSA personalized follow-up of HF patients led to important outcome benefits and resulted in cost savings, mainly due to the reduction of patient hospitalization readmissions and a significant reduction of care- associated costs, suggesting that greater attention should be given to this high-risk cohort to minimize the risk of hospitalization readmissions.

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