Characterizing patients with chronic heart failure in community care after hospitalization

a potential role for ivabradine

Douglas H. Elder, Mohapradeep Mohan, Lynda Cochrane, Helena Charles, Chim C. Lang (Lead / Corresponding author)

    Research output: Contribution to journalArticle

    7 Citations (Scopus)

    Abstract

    Aims: To identify the prevalence and characteristics of recently hospitalized chronic heart failure (CHF) patients in community care who meet the indication for ivabradine. Methods: A retrospective clinical audit of CHF patients recently hospitalized with acute decompensated heart failure (ADHF) and subsequently referred to the Tayside Heart Failure Nurse Liaison Service (THFNLS), a Scottish nurse-led community heart failure liaison service. Inclusion criteria were previous hospitalization with ADHF, subsequent referral to the THFNLS, data for ≥2 nurse visits, and a recorded pulse. The main outcome measure was the proportion of patients who meet the indicated criteria for ivabradine. Results: In the UK, ivabradine is indicated for CHF with systolic dysfunction in patients in sinus rhythm, with a heart rate ≥75 bpm, and NYHA class II-class IV. After up-titration of a beta-blocker, 19.0% of patients in the full dataset (158 of 830) met the indication for ivabradine at the last visit. Of these "ivabradine-suitable" patients, 101 of 158 (63.9%) received bisoprolol "at any time" during the study period; 20 of 158 (12.7%) achieved the target dose (10 mg daily); 52 of 158 (32.9%) received 5 mg or 7.5 mg daily; and 93 of 158 (58.9%) received <5 mg daily. Conclusions: In this group of Scottish patients previously hospitalized with ADHF and under the care of a protocol-driven clinic, 19% met the indication for ivabradine and may benefit from the increased control of CHF that ivabradine can provide. Among these "ivabradine-suitable" patients, <15% achieved the target dose of beta-blockers, illustrating the substantial clinical need for a well-tolerated and effective therapy such as ivabradine.

    Original languageEnglish
    Pages (from-to)104-108
    Number of pages5
    JournalCardiovascular Therapeutics
    Volume33
    Issue number3
    Early online date24 Mar 2015
    DOIs
    Publication statusPublished - Jun 2015

    Fingerprint

    ivabradine
    Hospitalization
    Heart Failure
    Nurses
    Bisoprolol
    Clinical Audit
    Systolic Heart Failure

    Keywords

    • Beta-blockers
    • Chronic heart failure
    • Clinical audit
    • Healthcare delivery
    • Heart rate reduction
    • Ivabradine

    Cite this

    Elder, Douglas H. ; Mohan, Mohapradeep ; Cochrane, Lynda ; Charles, Helena ; Lang, Chim C. / Characterizing patients with chronic heart failure in community care after hospitalization : a potential role for ivabradine. In: Cardiovascular Therapeutics. 2015 ; Vol. 33, No. 3. pp. 104-108.
    @article{440c5a110d5047b6b794b0559f2d48b9,
    title = "Characterizing patients with chronic heart failure in community care after hospitalization: a potential role for ivabradine",
    abstract = "Aims: To identify the prevalence and characteristics of recently hospitalized chronic heart failure (CHF) patients in community care who meet the indication for ivabradine. Methods: A retrospective clinical audit of CHF patients recently hospitalized with acute decompensated heart failure (ADHF) and subsequently referred to the Tayside Heart Failure Nurse Liaison Service (THFNLS), a Scottish nurse-led community heart failure liaison service. Inclusion criteria were previous hospitalization with ADHF, subsequent referral to the THFNLS, data for ≥2 nurse visits, and a recorded pulse. The main outcome measure was the proportion of patients who meet the indicated criteria for ivabradine. Results: In the UK, ivabradine is indicated for CHF with systolic dysfunction in patients in sinus rhythm, with a heart rate ≥75 bpm, and NYHA class II-class IV. After up-titration of a beta-blocker, 19.0{\%} of patients in the full dataset (158 of 830) met the indication for ivabradine at the last visit. Of these {"}ivabradine-suitable{"} patients, 101 of 158 (63.9{\%}) received bisoprolol {"}at any time{"} during the study period; 20 of 158 (12.7{\%}) achieved the target dose (10 mg daily); 52 of 158 (32.9{\%}) received 5 mg or 7.5 mg daily; and 93 of 158 (58.9{\%}) received <5 mg daily. Conclusions: In this group of Scottish patients previously hospitalized with ADHF and under the care of a protocol-driven clinic, 19{\%} met the indication for ivabradine and may benefit from the increased control of CHF that ivabradine can provide. Among these {"}ivabradine-suitable{"} patients, <15{\%} achieved the target dose of beta-blockers, illustrating the substantial clinical need for a well-tolerated and effective therapy such as ivabradine.",
    keywords = "Beta-blockers, Chronic heart failure, Clinical audit, Healthcare delivery, Heart rate reduction, Ivabradine",
    author = "Elder, {Douglas H.} and Mohapradeep Mohan and Lynda Cochrane and Helena Charles and Lang, {Chim C.}",
    note = "This article is protected by copyright. All rights reserved.",
    year = "2015",
    month = "6",
    doi = "10.1111/1755-5922.12117",
    language = "English",
    volume = "33",
    pages = "104--108",
    journal = "Cardiovascular Therapeutics",
    issn = "1755-5914",
    publisher = "Wiley",
    number = "3",

    }

    Characterizing patients with chronic heart failure in community care after hospitalization : a potential role for ivabradine. / Elder, Douglas H.; Mohan, Mohapradeep; Cochrane, Lynda; Charles, Helena; Lang, Chim C. (Lead / Corresponding author).

    In: Cardiovascular Therapeutics, Vol. 33, No. 3, 06.2015, p. 104-108.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Characterizing patients with chronic heart failure in community care after hospitalization

    T2 - a potential role for ivabradine

    AU - Elder, Douglas H.

    AU - Mohan, Mohapradeep

    AU - Cochrane, Lynda

    AU - Charles, Helena

    AU - Lang, Chim C.

    N1 - This article is protected by copyright. All rights reserved.

    PY - 2015/6

    Y1 - 2015/6

    N2 - Aims: To identify the prevalence and characteristics of recently hospitalized chronic heart failure (CHF) patients in community care who meet the indication for ivabradine. Methods: A retrospective clinical audit of CHF patients recently hospitalized with acute decompensated heart failure (ADHF) and subsequently referred to the Tayside Heart Failure Nurse Liaison Service (THFNLS), a Scottish nurse-led community heart failure liaison service. Inclusion criteria were previous hospitalization with ADHF, subsequent referral to the THFNLS, data for ≥2 nurse visits, and a recorded pulse. The main outcome measure was the proportion of patients who meet the indicated criteria for ivabradine. Results: In the UK, ivabradine is indicated for CHF with systolic dysfunction in patients in sinus rhythm, with a heart rate ≥75 bpm, and NYHA class II-class IV. After up-titration of a beta-blocker, 19.0% of patients in the full dataset (158 of 830) met the indication for ivabradine at the last visit. Of these "ivabradine-suitable" patients, 101 of 158 (63.9%) received bisoprolol "at any time" during the study period; 20 of 158 (12.7%) achieved the target dose (10 mg daily); 52 of 158 (32.9%) received 5 mg or 7.5 mg daily; and 93 of 158 (58.9%) received <5 mg daily. Conclusions: In this group of Scottish patients previously hospitalized with ADHF and under the care of a protocol-driven clinic, 19% met the indication for ivabradine and may benefit from the increased control of CHF that ivabradine can provide. Among these "ivabradine-suitable" patients, <15% achieved the target dose of beta-blockers, illustrating the substantial clinical need for a well-tolerated and effective therapy such as ivabradine.

    AB - Aims: To identify the prevalence and characteristics of recently hospitalized chronic heart failure (CHF) patients in community care who meet the indication for ivabradine. Methods: A retrospective clinical audit of CHF patients recently hospitalized with acute decompensated heart failure (ADHF) and subsequently referred to the Tayside Heart Failure Nurse Liaison Service (THFNLS), a Scottish nurse-led community heart failure liaison service. Inclusion criteria were previous hospitalization with ADHF, subsequent referral to the THFNLS, data for ≥2 nurse visits, and a recorded pulse. The main outcome measure was the proportion of patients who meet the indicated criteria for ivabradine. Results: In the UK, ivabradine is indicated for CHF with systolic dysfunction in patients in sinus rhythm, with a heart rate ≥75 bpm, and NYHA class II-class IV. After up-titration of a beta-blocker, 19.0% of patients in the full dataset (158 of 830) met the indication for ivabradine at the last visit. Of these "ivabradine-suitable" patients, 101 of 158 (63.9%) received bisoprolol "at any time" during the study period; 20 of 158 (12.7%) achieved the target dose (10 mg daily); 52 of 158 (32.9%) received 5 mg or 7.5 mg daily; and 93 of 158 (58.9%) received <5 mg daily. Conclusions: In this group of Scottish patients previously hospitalized with ADHF and under the care of a protocol-driven clinic, 19% met the indication for ivabradine and may benefit from the increased control of CHF that ivabradine can provide. Among these "ivabradine-suitable" patients, <15% achieved the target dose of beta-blockers, illustrating the substantial clinical need for a well-tolerated and effective therapy such as ivabradine.

    KW - Beta-blockers

    KW - Chronic heart failure

    KW - Clinical audit

    KW - Healthcare delivery

    KW - Heart rate reduction

    KW - Ivabradine

    UR - http://www.scopus.com/inward/record.url?scp=84929153521&partnerID=8YFLogxK

    U2 - 10.1111/1755-5922.12117

    DO - 10.1111/1755-5922.12117

    M3 - Article

    VL - 33

    SP - 104

    EP - 108

    JO - Cardiovascular Therapeutics

    JF - Cardiovascular Therapeutics

    SN - 1755-5914

    IS - 3

    ER -