Archives of Cardiovascular Diseases Supplements | 2019
Setting up the program ‘PRADO Insuffisance Cardiaque’ (back home program for heart failure patients): Perception by health professionals and patients
Abstract
Re-hospitalizations and deaths are particularly high during the first month following hospitalization for IC. Thus, several programs have been proposed in recent years, including the ‘Programme d’Accompagnement du Retour a Domicile(PRADO)’. The objectives of this program are to reduce the re-hospitalization and death of IC patients and to improve their quality of life. This is a monocentric observational retrospective study whose main objective was to evaluate the feeling of general practitioners,cardiologists and community nurses in the implementation of the PRADO IC program. The secondary objectives were to determine the impact of the program on the number of re-hospitalizations and deaths within 6 months following hospitalization. It was also to evaluate the feelings of the patients included.60 physicians and 36 community nurses participated in our study as well as 56 patients. The knowledge of the protocol concerned only 28% of general practitioners and 80% of cardiologists (significant difference between specialties). The majority of health professionals seem to favor this program. The 6-month re-hospitalization rate for IC was 21.6%. None of the triggering factors corresponded to a therapeutic break or a difference in diet, suggesting that the therapeutic education sessions of the program have borne fruit. An advanced age,outpatient BNP\xa0≥\xa0400\xa0pg/mL, and impaired LVEF were correlated with increased risk of re-hospitalization (no statistically significant link). We also found a trend toward shorter re-hospitalizations. Mortality at 6 months was 18.2%. Older age (>\xa085 years) was statistically associated with a higher risk of cardiovascular mortality. The majority of patients reported having felt a benefit to carry out this program, because it was accessible in its content and easy to set up at home. In conclusion, the low knowledge of the program should allow for new effective dissemination methods for this type of program as the prevalence of HF will continue to grow in the coming years.