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Int J Cardiol Heart Vasc. 2019 Mar 7;22:169-173. doi: 10.1016/j.ijcha.2019.02.010. eCollection 2019 Mar.

Effect of the Optimize Heart Failure Care Program on clinical and patient outcomes - The pilot implementation in Vietnam.

Author information

1
Scientific Research and Formation, Ho Chi Minh city Heart Institute, Viet Nam.
2
Pham Ngoc Thach University of Medicine at Ho Chi Minh City, Ho Chi Minh city Heart Institute, Viet Nam.
3
National Heart and Lung Institute, Imperial College London (Royal Brompton Hospital), London, UK.
4
Department of Intensive Care and Cardiology, Ho Chi Minh city Heart Institute, Viet Nam.
5
University of Medicine and Pharmacy at Ho Chi Minh city, Viet Nam.
6
Department of Consultation, Ho Chi Minh city Heart Institute, Viet Nam.
7
Department of Cardiology, Ho Chi Minh city Heart Institute, Viet Nam.
8
Department of Intensive Care and Emergency, Ho Chi Minh city Heart Institute, Viet Nam.
9
Department of Hospitalization B, Ho Chi Minh city Heart Institute, Viet Nam.
10
Department of Nutrition, Ho Chi Minh city Heart Institute, Viet Nam.
11
Department of Hospitalization A, Ho Chi Minh city Heart Institute, Viet Nam.

Abstract

Background:

The Ho-Chi-Minh-city Heart Institute in Vietnam took part in the Optimize Heart Failure (OHF) Care Program, designed to improve outcomes following heart failure (HF) hospitalization by increasing patient awareness and optimizing HF treatment.

Methods:

HF patients hospitalized with left ventricular ejection-fraction (LVEF) <50% were included. Patients received guideline-recommended HF treatment and education. Clinical signs, treatments and outcomes were assessed at admission, discharge, 2 and 6 months (M2, M6). Patients' knowledge and practice were assessed at M6 by telephone survey.

Results:

257 patients were included. Between admission and M2 and M6, heart rate decreased significantly, and clinical symptoms improved significantly. LVEF increased significantly from admission to M6. 85% to 99% of patients received education. At M6, 45% to 78% of patients acquired knowledge and adhered to practice regarding diet, exercise, weight control, and detection of worsening symptoms. High use of renin-angiotensin-aldosterone-system inhibitors (91%), mineralocorticoid-receptor-antagonists (77%) and diuretics (85%) was noted at discharge. Beta-blocker and ivabradine use was less frequent at discharge but increased significantly at M6 (from 33% to 51% and from 9% to 20%, respectively, p < 0.001). There were no in-hospital deaths. Readmission rates at 30 and 60 days after discharge were 8.3% and 12.5%, respectively. Mortality rates at 30 days, 60 days and 6 months were 1.2%, 2.5% and 6.4%, respectively.

Conclusions:

The OHF Care Program could be implemented in Vietnam without difficulty and was associated with high usage of guideline-recommended drug therapy. Although education was delivered, patient knowledge and practice could be further improved at M6 after discharge.

KEYWORDS:

Education; Heart failure; Knowledge; Mortality; Optimize; Readmission

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