Biomarkers-based personalized follow-up in chronic heart failure improves patient’s outcomes and reduces care associate cost.
Abstract BACKGROUND Heart 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 with a reduced left ventricular ejection fraction (HFrEF).METHODS This is a real-world, before and after interventional study, 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 the intervention and again after the intervention. The primary objective was the rate of readmissions, due to a HF. Secondary outcome compared the rate of ED visits and quality of life improvement assessed by the number of patients who had reduced NYHA score. A cost- analysis was also performed on these data. RESULTS Admission rates significantly decreased by 65,6% after the intervention, the total hospital admissions were reduced by 41% and the total length of stay was reduced by 46%. 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.CONCLUSIONS A 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.