Holistic Care Providing of Chronic Heart Failure Patients by Establishing the Heart Failure Clinic in Standard (S)-Level Banpong Hospital

Abstract

Objective: This was study the results of patients after enrolling in heart failure clinic in a standard (S)-level hospital.

Methods: A Retrospective descriptive study was done. Data were gathered from medical records of patients with chronic heart failure who confirmed to the inclusion criteria, and registered in heart failure clinic, under supervision of multidisciplinary team, from 1 July 2019 to 1 October 2020.

Results: Of total 65 patients in the study, all had LVEF less than 40%. The patients aged 21-87 years and 64.6% were males, 35.4% were females. All patients were received at least one standard regimen of treatment for chronic heart failure; ACEI/ARB, B-blocker, MRA, ARNI, and SGLT-2 inhibitor. After registering with heart failure clinic, primary outcome revealed that the patients’ rate of re-hospitalization in 1 year decreased from 32.3 % to 16.9 % (p < .001). Secondary outcomes were such as a decline in number of patients with NYHA LVEF FC III and IV from 73.9% to 7.7% (p < .001), significant increase in LVEF by 18.59% (p < .001), and improvement of cardiac performance by 6MWT (p < .001). Number of patients expired during study was 9 (13.8%), which one was declared from heart failure.

Conclusion: Role of multidisciplinary team includes physician, pharmacist, dietician, and cardiac rehabilitation team significantly plays in remedy of chronic heart failure patients. The registered patients receive adequate medicine and comprehension of health care for ones with disease which decrease the re-hospitalization rate, lessen severity of the illness, improve cardiac function, and quality of life.