Effect of the Optimize Heart Failure Care Program on clinical and patient outcomes – The pilot implementation in Vietnam

• Main Authors: Thi Nam Phuong Do, Quang Huan Do, Martin R. Cowie, Ngoc Ban Ha, Van Dung Do, Thi Hao Do, Thi Thuy Hang Nguyen, Thuy Loan Tran, Thi Ngoc Oanh Nguyen, Thi My Hanh Nguyen, Thi To Quyen Chau, Thi Tuyen Tien Nguyen, Chi Thanh Nguyen, Kieu Diem Trang Tran, Thi Nha Diem Nguyen, Ngoc Yen Tuyet Nguyen, Kim Tuyen Le, Thanh Thu Phan, Thi Lan Vo, Thuy Dung Huynh, Thi Mai Hoa Pham, Thi Anh Thu Nguyen, Xuan Nguyen Nguyen, Thi Ngoc Thuy Tran, Thi Ngoc Quyen Truong, Bao Thanh Bui, Thanh Quang Bui, Quoc Thanh Ha, Cam Thuy Truc La, Phat Tai Le, Huu Duc Nguyen, Thuc Linh Nguyen, Ngoc Manh Tran
• Format: Article
• Language: English
• Published: Elsevier 2019-03-01
• Series: International Journal of Cardiology: Heart & Vasculature
• Online Access: http://www.sciencedirect.com/science/article/pii/S2352906718301489

Background: The Ho-Chi-Minh-city Heart Institute in Vietnam took part in the Optimize Heart Failure (OHF) Care Program, designed to improve outcomes following heart failure (HF) hospitalization by increasing patient awareness and optimizing HF treatment. Methods: HF patients hospitalized with left ventricular ejection-fraction (LVEF) <50% were included. Patients received guideline-recommended HF treatment and education. Clinical signs, treatments and outcomes were assessed at admission, discharge, 2 and 6 months (M2, M6). Patients' knowledge and practice were assessed at M6 by telephone survey. Results: 257 patients were included. Between admission and M2 and M6, heart rate decreased significantly, and clinical symptoms improved significantly. LVEF increased significantly from admission to M6. 85% to 99% of patients received education. At M6, 45% to 78% of patients acquired knowledge and adhered to practice regarding diet, exercise, weight control, and detection of worsening symptoms. High use of renin-angiotensin-aldosterone-system inhibitors (91%), mineralocorticoid-receptor-antagonists (77%) and diuretics (85%) was noted at discharge. Beta-blocker and ivabradine use was less frequent at discharge but increased significantly at M6 (from 33% to 51% and from 9% to 20%, respectively, p < 0.001). There were no in-hospital deaths. Readmission rates at 30 and 60 days after discharge were 8.3% and 12.5%, respectively. Mortality rates at 30 days, 60 days and 6 months were 1.2%, 2.5% and 6.4%, respectively. Conclusions: The OHF Care Program could be implemented in Vietnam without difficulty and was associated with high usage of guideline-recommended drug therapy. Although education was delivered, patient knowledge and practice could be further improved at M6 after discharge. Keywords: Heart failure, Optimize, Education, Knowledge, Mortality, Readmission