Los Angeles-based Smidt Heart Institute at Cedars-Sinai researchers found that a phone call intervention program reduced death rates by 25 percent for patients discharged after heart failure with nine or more comorbidities.
The study, published in the Journal of Cardiac Failure on Dec. 12, followed 1,313 patients 50 years and older who were hospitalized for acute decompensated heart failure between October 2011 and September 2013. Patients were grouped by the number of their comorbidities. The low comorbidity group had zero to two comorbidities, the moderate group had three to eight comorbidities, and the high group had nine or more comorbidities.
Within comorbidity groups, patients were divided into two care plans: the usual care, which consists of a nurse educatingon patients about heart failure before they are discharged and following up with one phone call, and the new post-hospital care plan, where patients receive pre-discharge heart failure education, a blood pressure monitor and scale, and an average of five calls over a 180-day period. Nurses scheduled regular phone calls to ask about weight, blood pressure, heart rate and any unusual symptoms. Patients who reported unusual symptoms received more follow-up calls.
Patients in the high comorbidity group who received the new intervention were 25 percent less likely to die at 30 days and 180 days. They also stayed out of the hospital for a mean of 152 days, compared to the control group with a mean of 133 days.
Patients in the low and moderate comorbidity groups who received the new intervention had no statistically significant different outcomes. The readmission rates were also similar between the new intervention and the control groups.