Chronic care for heart failure patients: Who to refer back to the general practitioner?—Experiences of the Dutch integrated heart failure care model

Abstract Objective The number of patients with heart failure (HF) and corresponding burden of the healthcare system will increase significantly. The Dutch integrated model, ‘Transmural care of HF Patients’ was based on the European Society of Cardiology (ESC) guidelines and initiated to manage the increasing prevalence of HF patients in primary and secondary care and stimulate integrated care. It is unknown how many HF patients are eligible for back‐referral to general practitioners (GPs), which is important information for the management of chronic HF care. This study aims to evaluate clinica... Mehr ...

Verfasser: Vester, Marijke
Beeres, Saskia
Lucas, Carolien
van Pol, Petra
Schalij, Martin
Bonten, Tobias
van Dijkman, Paul
Tops, Laurens
Dokumenttyp: Artikel
Erscheinungsdatum: 2023
Reihe/Periodikum: Journal of Evaluation in Clinical Practice ; volume 30, issue 2, page 209-216 ; ISSN 1356-1294 1365-2753
Verlag/Hrsg.: Wiley
Schlagwörter: Public Health / Environmental and Occupational Health / Health Policy
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-26690816
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : http://dx.doi.org/10.1111/jep.13937

Abstract Objective The number of patients with heart failure (HF) and corresponding burden of the healthcare system will increase significantly. The Dutch integrated model, ‘Transmural care of HF Patients’ was based on the European Society of Cardiology (ESC) guidelines and initiated to manage the increasing prevalence of HF patients in primary and secondary care and stimulate integrated care. It is unknown how many HF patients are eligible for back‐referral to general practitioners (GPs), which is important information for the management of chronic HF care. This study aims to evaluate clinical practice of patients for whom chronic HF care can be referred from the cardiologist to the GP based on the aforementioned chronic HF care model. Design and Methods A retrospective case record‐based study was conducted, which included all chronic HF patients registered in the cardiology information systems of two different hospitals. Subsequently, 200 patients were randomly selected for evaluation. The following patients were considered eligible for referral to the GP: 1/Stable HF patients with reduced left ventricular ejection fraction (LVEF), 2/Stable HF patients with a recovered LVEF and 3/Stable HF patients with a preserved LVEF, 4/HF, palliative setting. Results Of the 200 patients, 17% was considered eligible for referral to the GP. This group consisted of 5% patients with a reduced LVEF, 10.5% patients with recovered LVEF and 1.5% patients with a preserved LVEF. Main indicators for HF care by cardiologists were active cardiac disease other than HF (39.5%), recent admission for HF (29.5%) or a recent adjustment in HF medication (7.5%). Conclusion Applying the chronic HF care model of the ‘Transmural care of HF patients’ and the ESC‐guidelines, results in an important opportunity to further optimise HF integrated care and to deal with the increasing number of HF patients referred to the hospital.