Abstract:
AIM:To evaluate the efficacy and feasibility of hospital and community management in patients with chronic heart failure. METHODS: Ten communities in Putuo District were included in this study and a total of 120 patients with heart failure (New York Heart Function II-IV) visiting Putuo District Center Hospital from September 2009 to March 2011 were investigated. The patients were divided into two groups: management group (n=59) and control group (n=57). In the management group, the community hospital doctors were trained according to the standardized guidelines for the management of heart failure. Patients received self-care education by center hospital doctors, whereas patients in the control group were treated without special training. The two groups were observed in the aspects of patients’ knowledge about heart failure, standardized medication, level of self-care in daily life, major adverse cardiac events, and hospitalization time. RESULTS: No significant differences were observed between groups at baseline. After an 18-month follow-up, the rate of patients’ knowledge about heart failure (100% vs. 81%, P<0.05), rate of standardized medication [diuretics (92% vs. 54%, P<0.05), beta-blockers (95% vs. 58%, P<0.05), ACEI/ARB (93% vs. 58%, P<0.05)] and rate of self-care in daily life [salt restriction (92% vs. 25%, P<0.05), stopping smoking (52% vs. 25%, P<0.05), physical exercise (51% vs. 18%, P<0.05), blood pressure and heart rate monitoring (93% vs. 23%, P<0.05)], and days of hospitalization [(8.3±2.2) days vs. (9.2±2.1) days, P<0.05] in the management group were higher than those in the control group. The rate of MACE was lower (8% vs. 9%, P>0.05) in the management group than in the control group. CONCLUSION: Hospital and community management in patients with chronic heart failure is feasible and effective.