Association of a Transitional Heart Failure Management Program With Readmission and End-of-Life Care in Rural Japan.

Autor:	Kinugasa Y; Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University Yonago Japan., Nakamura K; Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University Yonago Japan., Hirai M; Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University Yonago Japan., Manba M; Division of Nursing, Tottori University Hospital Yonago Japan., Ishiga N; Division of Rehabilitation, Tottori University Hospital Yonago Japan., Sota T; Division of Rehabilitation, Tottori University Hospital Yonago Japan., Nakayama N; Division of Nutrition, Tottori University Hospital Yonago Japan., Ohta T; Division of Pharmacy, Tottori University Hospital Yonago Japan., Kato M; Department of Pathobiological Science and Technology, School of Health Science, Faculty of Medicine, Tottori University Yonago Japan., Adachi T; Adachi Clinic Yonago Japan., Fukuki M; Department of Cardiology, Yonago Medical Center Yonago Japan., Hirota Y; Tomimasu Medical and Dental Clinic Yonago Japan., Mizuta E; Department of Cardiology, Sanin Rosai Hospital Yonago Japan., Mura E; Visiting Nurse Station Nanbu Kohoen Yonago Japan., Nozaka Y; Nozaka Clinic Yonago Japan., Omodani H; Omodani Internal Medicine and Cardiovascular Medicine Clinic Yonago Japan., Tanaka H; Department of Cardiology, Tottori Prefecture Sakaiminato General Hospital Sakaiminato Japan., Tanaka Y; Department of Cardiology, Hakuai Hospital Yonago Japan., Watanabe I; Department of Nursing, Sanin Rosai Hospital Yonago Japan., Mikami M; Hoshoji Clinic Nanbucho Japan., Yamamoto K; Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University Yonago Japan.
Jazyk:	angličtina
Zdroj:	Circulation reports [Circ Rep] 2024 Apr 20; Vol. 6 (5), pp. 168-177. Date of Electronic Publication: 2024 Apr 20 (Print Publication: 2024).
DOI:	10.1253/circrep.CR-24-0030
Abstrakt:	Background: Evidence on transitional care for heart failure (HF) in Japan is limited. Methods and Results: We implemented a transitional HF management program in rural Japan in 2019. This involved collaboration with general practitioners or nursing care facilities and included symptom monitoring by medical/nursing staff using a handbook; standardized discharge care planning and information sharing on self-care and advance care planning using a collaborative sheet; and sharing expertise on HF management via manuals. We compared the outcomes within 1 year of discharge among patients hospitalized with HF in the 2 years before program implementation (2017-2018; historical control, n=198), in the first 2 years after program implementation (2019-2020; Intervention Phase 1, n=205), and in the second 2 years, following program revision and regional dissemination (2021-2022; Intervention Phase 2, n=195). HF readmission rates gradually decreased over Phases 1 and 2 (P<0.05). This association was consistent regardless of physician expertise, follow-up institution, or the use of nursing care services (P>0.1 for interaction). Mortality rates remained unchanged, but significantly more patients received end-of-life care at home in Phase 2 than before (P<0.05). Conclusions: The implementation of a transitional care program was associated with decreased HF readmissions and increased end-of-life care at home for HF patients in rural Japan. Competing Interests: Y.K. has received lecturer fees from AstraZeneca Co. Ltd and Boehringer Ingelhem Co., Ltd. K.Y. has received research grants from Abbott Co., Ltd., Otsuka Pharmaceutical Co., Ltd., Biotronik Japan Inc., Japan Lifeline Co., Ltd., Fukuda Denshi; Medtronic Japan Co., Ltd., and Boston Scientific Co., Ltd., as well as lecturer fees from Otsuka Pharmaceutical Co., Ltd., Novartis, Daiichi-Sankyo Co. Ltd., and Bayer Yakuhin Ltd. The remaining authors have no conflicts of interest to declare. (Copyright © 2024, THE JAPANESE CIRCULATION SOCIETY.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu