Comprehensive multidisciplinary programs for the management of patients with congestive heart failure

Abstract

OBJECTIVE: To evaluate the impact of comprehensive, multidisciplinary management programs on the process of care, resource utilization, health care costs, and clinical outcomes in patients with congestive heart failure. MEASUREMENTS AND MAIN RESULTS: A MEDLINE search identified seven english- language reports that compared the process of care, clinical outcomes, or economic variables related to implementation of a multidisciplinary congestive heart failure management program of at least 3 month's duration to a control or reference group. The primary intent of the programs was to emphasize compliance with recommended therapeutic principles, enhance patient education, and provide careful patient surveillance. Five of the studies reported improved functional status, aerobic capacity, or patient satisfaction. Six of the studies reported a 50% to 85% reduction in the risk of hospital admission. Three studies reported economic analyses with suggestive but not compelling evidence of financial benefit. CONCLUSIONS: Comprehensive, multidisciplinary management programs for congestive heart failure can improve functional status and reduce the risk of hospital admission, and they may lower medical costs.