Evidence map›Paper›PMID 36178015›Full record

Trial reportESC heart failure2023

Effects of multifaceted optimization management for chronic heart failure: a multicentre, randomized controlled study.

Guangming Pan, Weiqiang Ji, Xia Wang, Song Li, Chaoyang Zheng, Weihui Lyu, Xiaoyan Feng, Yu Xia, Zhihua Xiong, Haohong Shan and 2 more

Open access · goldAbstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in ESC heart failure, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.1field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 2 countries.

Guangming PanGuangdong Provincial Hospital of Chinese Medicine; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.ORCID https://orcid.org/0000-0002-7601-6389
Weiqiang JiThe Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.ORCID https://orcid.org/0000-0001-7058-0635
Xia WangGuangdong Provincial Hospital of Chinese Medicine; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Song LiGuangdong Provincial Hospital of Chinese Medicine; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Chaoyang ZhengGuangdong Provincial Hospital of Chinese Medicine; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Weihui LyuGuangdong Provincial Hospital of Chinese Medicine; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Xiaoyan FengYangjiang Hospital of Traditional Chinese Medicine, Yangjiang, Guangdong, China.
Yu XiaQingyuan Hospital of Traditional Chinese Medicine, Qingyuan, Guangdong, China.
Zhihua XiongGuangzhou Baiyun Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China.
Haohong ShanGuangzhou Zengcheng District Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China.
Haiyu YangJiangmen Wuyi Hospital of Traditional Chinese Medicine, Jiangmen, Guangdong, China.
Xu ZouGuangdong Provincial Hospital of Chinese Medicine; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.ORCID https://orcid.org/0000-0002-6489-6227
Guangzhou University of Chinese Medicine · CNGuangdong Provincial Hospital of Traditional Chinese Medicine · CNJiangmen Wuyi Traditional Chinese Medicine Hospital · CNQujiang People's Hospital · CNXiyuan Hospital · CN

Funding

Specific Research Fund for TCM Science and Technology of Guangdong Provincial Hospital of Chinese Medicine YN2015MS10Studio of Lingnan Deng's Internal Medicine School and the Studio of Xu Zou, Guangdong Provincial Famous Doctor of TCM
6 · The paper itself

Abstract

aimsIn recent years, we have developed the concept of 'clinical pathway based on integrated traditional Chinese and western medicine for the management of Chronic heart failure (CHF)'. The purpose of this study was to assess the implementation effects of multifaceted optimization management of chronic heart failure.

methodsA total of nine physicians in optimization group from nine research sites received multifaceted intervention (a 1-day training session on how to implement the optimization programme, a written optimization programme for CHF management, supervision from daily quality coordinator, and 1-monthly monitoring and feedback of performance measure) with respect to the management of CHF, comparing to nine physicians in control group who did not receive the aforementioned multifaceted intervention and diagnosed and treated CHF patients with conventional programme (usual care). After that, a total of 256 patients with CHF were enrolled and randomly assigned to receive optimization programme [integration of usual care and traditional Chinese medicine (TCM) treatment] or conventional programme (usual care) for the treatment of CHF. The primary outcome was the change in New York Heart Association (NYHA) functional classification during 24 weeks of treatment.

resultsWhen compared with usual care, multifaceted optimization management resulted in superior improvements in NYHA functional classification at the 12-week visit (P = 0.023), the 16-week, 20-week, and 24-week visits (P < 0.001). It also demonstrated superior performance in comparison with the conventional programme with respect to readmission rate for major adverse cardiovascular events (MACEs), readmission rate for worsening heart failure, plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) level, left ventricular ejection fraction (LVEF), patient TCM syndrome scores, quality of life, and patients with heart failure with reduced ejection fraction (HFrEF) in optimization group more likely received beta-blockers and ACE inhibitors or ARBs than those in control group (P = 0.038 and P = 0.013, respectively).

conclusionsIt is likely that the multifaceted optimization programme used in this study is feasible would benefit patients with CHF in NYHA functional classification, readmission for worsening heart failure, plasma NT-proBNP level, LVEF, patient TCM syndrome scores, and quality of life. Additionally, it would improve hospital personnel adherence to evidence-based performance measures for HFrEF.

Indexed as

Heart FailureAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsChronic DiseaseHumansQuality of LifeStroke VolumeVentricular Function, LeftAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsChronic heart failureImplementationOptimizationRandomized controlled trialTraditional Chinese medicine

Identifiers

PMID36178015
PMCPMC9871673
OpenAlexW4298087847

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.