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JAMA: Hospital to Home Care for Heart Failure Patients

Dr. Harriette Van Spall, PHRI investigator
Dr. Harriette Van Spall, PHRI investigator

The Journal of the American Medical Association (JAMA) has published “Effect of Patient-Centered Transitional Services on Clinical Outcomes in Patients Hospitalized for Heart Failure” about the results of the PHRI-led PACT-HF study. The first author, and the study’s principal investigator, is Dr. Harriette Van Spall, a researcher in the knowledge translation and heart failure programs at PHRI, associate professor in the Department of Medicine at McMaster University, and a cardiologist at Hamilton Health Sciences.

The study, which followed the health status of almost 2,500 adults hospitalized for heart failure at 10 hospitals across Ontario between February 2015 and March 2016, found that providing additional health care services to help them transition from hospital to home does not improve their outcome. There were no significant differences in death, readmissions or emergency department visits between the patients who received the transitional care intervention, and those who received usual care.

However, “patients receiving the intervention reported improvements in discharge preparedness, quality of transitional care, and quality of life,” says Van Spall. She added that further research could help determine whether this type of intervention could be effective in other health-care systems or locations.

For the study, hospitals were randomized to receive the hospital-to-home transition care intervention. This intervention, delivered to 1,104 patients, included nurse-led self-care education, a structured hospital discharge summary, and a family physician follow-up appointment less than one week after discharge and, for high-risk patients, structured nurse home visits and heart function clinic care. The remainder of the patients received usual care in which transitional care was left to the discretion of clinicians.

The PACT-HF study was conducted due to the knowledge that “approximately 40% of early readmissions after heart failure hospitalizations are related to suboptimal care as patients transfer between health-care settings,” says Van Spall.

Read the JAMA article.