Giving intravenous iron to patients with symptomatic heart failure is safe and cost effective

2021 ◽  
pp. 1-5
Author(s):  
James Redfern ◽  
Rachel Goode ◽  
Wing Yin Leung ◽  
Clare Quarterman ◽  
Archana Rao
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
New York ◽  
Heart Association ◽  
Intravenous Iron ◽  
Cost Effective ◽  
Ferric Carboxymaltose ◽  
Association Class ◽  
New York Heart Association

Aims/Background Heart failure affects approximately 1 million people in the UK, adversely affecting quality of life, functional capacity and cognitive health. Iron deficiency complicates heart failure in approximately 50% of patients. Giving intravenous ferric carboxymaltose has been shown to improve quality of life in patients with heart failure (New York Heart Association class and Kansas City Cardiomyopathy Questionnaire). Methods A quality improvement project was designed to assess the feasibility, safety and cost implications of establishing an intravenous iron service in the authors' centre. Results Between July and December 2019 61 patients who were screened met the inclusion criteria and were administered intravenous ferric carboxymaltose. There were statistically significant improvements in ferritin levels (83.3 ug/litre to 433 ug/litre; P<0.0001), transferrin saturation (18% to 30% P<0.0001) and haemoglobin levels (126 g/litre to 135 g/litre; P<0.01). No demonstrable changes in New York Heart Association class or quality of life scores were noted. The overall financial impact for the trust was income generation of £14 665, a net income of £240 per patient. Conclusions Intravenous iron replacement with ferric carboxymaltose is safe and cost effective, and should be considered in eligible iron-deficient patients with symptomatic heart failure. Integration with another day case intravenous service represented the most logistically simple and economically viable method of service delivery.

Evaluation of the effectiveness of a phase three specialised heart failure cardiac rehabilitation programme on cardiovascular risk factor profile

2021 ◽  
pp. 1-10
Author(s):  
Noeleen Fallon ◽  
Mary Quirke ◽  
Caroline Edgeworth ◽  
Rose O'Mahony ◽  
Nora Flynn ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
New York ◽  
Cardiac Rehabilitation ◽  
Heart Association ◽  
Rehabilitation Programme ◽  
Cardiac Rehabilitation Programme ◽  
Association Class ◽  
New York Heart Association

Background/Aims Cardiac rehabilitation has long been seen as effective for many cardiovascular diseases and, more recently, as having a positive impact on patients with heart failure. To evaluative the effectiveness of a phase three specialised heart failure cardiac rehabilitation programme on patients' cardiovascular risk factor profile. Methods This retrospective, longitudinal study examined profile factors of patients, pre- and post-cardiac rehabilitation programme. Patients with New York Heart Association class I–III, of any origin, were recruited through a specialised heart failure service to a 10-week exercise and education programme. Outcome variables included anxiety, depression, quality of life (Minnesota), 6-minute walking test result, blood pressure, weight, waist circumference, body mass index, Duke Activity Status Index and self-care, and were analysed with the Statistical Package for the Social Sciences using repeated measures t-test. Results 100 patients were eligible and 85 patients completed the programmes. Mean age was 66 years, 80% male, 59% were New York Heart Association class I and 73% had ejection fraction of ≤40%. There was a significant improvement in 6-minute walking test, systolic blood pressure, quality of life and anxiety post programme. Conclusions In-hospital and out of hospital cardiac care has developed significantly, especially in acute symptom control. More recently, emphasis has been put on the long-term control of other risk factors. This study contributes to the literature indicating that attendance at a hospital-based phase three cardiac rehabilitation programme providing supervised, tailored exercise, with intensive education and psychological support, is effective in reducing risk factors and improving quality of life in patients with lower grades of heart failure.

scholarly journals Cost-utility analysis of an implantable cardioverterdefibrillator for the treatment of patients with ischemic or non-ischemic New York Heart Association class II or III heart failure in Colombia

Biomédica ◽  
2019 ◽  
Vol 39 (3) ◽  
pp. 502-512
Author(s):  
Sara Atehortúa ◽  
Juan Manuel Senior ◽  
Paula Castro ◽  
Mateo Ceballos ◽  
Clara Saldarriaga ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Implantable Cardioverter Defibrillator ◽  
Heart Association ◽  
Cost Effective ◽  
Cost Utility ◽  
Cardioverter Defibrillator ◽  
Association Class ◽  
New York Heart Association ◽  
Quality Adjusted Life

Introduction: The use of an implantable cardioverter-defibrillator reduces the probability of sudden cardiac death in patients with heart failure.Objective: To determine the cost-utility relationship of an implantable cardioverter-defibrillator compared to optimal pharmacological therapy for patients with ischemic or non-ischemic New York Heart Association class II or III (NYHA II-III) heart failure in Colombia.Materials and methods: We developed a Markov model including costs, effectiveness, and quality of life from the perspective of the Colombian health system. For the baseline case, we adopted a time horizon of 10 years and discount rates of 3% for costs and 3.5% for benefits.The transition probabilities were obtained from a systematic review of the literature. The outcome used was the quality-adjusted life years. We calculated the costs by consulting with the manufacturers of the device offered in the Colombian market and using national-level pricing manuals. We conducted probabilistic and deterministic sensitivity analyses.Results: In the base case, the incremental cost-effectiveness ratio for the implantable cardioverter-defibrillator was USD$ 13,187 per quality-adjusted life year gained. For a willingness-to-pay equivalent to three times the gross domestic product per capita as a reference (USD$ 19,139 in 2017), the device would be a cost-effective strategy for the Colombian health system. However, the result may change according to the time horizon, the probability of death, and the price of the device.Conclusions: The use of an implantable cardioverter-defibrillator for preventing sudden cardiac death in patients with heart failure would be a cost-effective strategy for Colombia. The results should be examined considering the uncertainty.

Factors associated with health-related quality of life in stable ambulatory congestive heart failure patients: Systematic review

2018 ◽  
Vol 25 (5) ◽  
pp. 472-481 ◽  
Author(s):  
Anneleen Baert ◽  
Delphine De Smedt ◽  
Johan De Sutter ◽  
Dirk De Bacquer ◽  
Paolo Emilio Puddu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
New York ◽  
Congestive Heart Failure ◽  
Heart Association ◽  
Functional Class ◽  
Factors Associated ◽  
Related Quality ◽  
New York Heart Association

Background Since improved treatment of congestive heart failure has resulted in decreased mortality and hospitalisation rates, increasing self-perceived health-related quality of life (HRQoL) has become a major goal of congestive heart failure treatment. However, an overview on predictieve factors of HRQoL is currently lacking in literature. Purpose The aim of this study was to identify key factors associated with HRQoL in stable ambulatory patients with congestive heart failure. Methods A systematic review was performed. MEDLINE, Web of Science and Embase were searched for the following combination of terms: heart failure, quality of life, health perception or functional status between the period 2000 and February 2017. Literature screening was done by two independent reviewers. Results Thirty-five studies out of 8374 titles were included for quality appraisal, of which 29 were selected for further data extraction. Four distinct categories grouping different types of variables were identified: socio-demographic characteristics, clinical characteristics, health and health behaviour, and care provider characteristics. Within the above-mentioned categories the presence of depressive symptoms was most consistently related to a worse HRQoL, followed by a higher New York Heart Association functional class, younger age and female gender. Conclusion Through a systematic literature search, factors associated with HRQoL among congestive heart failure patients were investigated. Age, gender, New York Heart Association functional class and depressive symptoms are the most consistent variables explaining the variance in HRQoL in patients with congestive heart failure. These findings are partly in line with previous research on predictors for hard endpoints in patients with congestive heart failure.

Sign in / Sign up

Export Citation Format

Share Document