A Heart Failure Management Program Using Shared Medical Appointments.

backgroundDisease management programs for heart failure (HF) effectively reduce HF-related hospitalization rates and mortality. Shared medical appointments (SMAs) offer a cost-effective delivery method for HF disease management programs. However, few studies have evaluated this cost-effective delivery method of HF disease management among Veterans with acute HF. We hypothesized that Veterans who attended a multidisciplinary HF-SMA clinic promoting HF self-management, compared those who only received individual treatment through the HF specialty clinic, would have better 12-month hospitalization outcomes.

methodsWe completed a retrospective review of the VA electronic health record for HF-SMA clinic appointments (1/1/2012 to 12/31/2013). The multidisciplinary HF-SMA program comprised 4 weekly sessions covering topics including HF disease, HF medications, diet adherence, physical activity, psychological well-being, and stress management. Patients who attended the HF-SMA clinic (

resultsOf 141 patients scheduled for an HF-SMA clinic appointment, 54 met criteria for the HF-SMA clinic group and 37 were included in the HF clinic group. The groups did not significantly differ on any sociodemographic variables. Furthermore, no significant differences were observed between the HF-SMA group and the HF clinic group on demographics or hospitalization outcomes,

conclusionsOur results did not support our hypothesis that offering multidisciplinary, HF-SMAs promoting HF self-management skills, above and beyond the individual disease management care provided in an HF specialty clinic, would improve hospitalization outcomes among Veterans with acute HF. Limitations of the present study and recommendations for HF self-management programs for Veterans are discussed.