VA Heart Failure Clinic Reduces Readmission Rates Nearly 85%

By Annette M. Boyle

Freny Mody, MD

LOS ANGELES—Appropriate and consistent use of medications markedly slows the progression of heart failure and reduces its mortality. Despite the clear benefits of medication, the number of heart failure patients who are nonadherent remains stubbornly high, however.

The VA Greater Los Angeles Healthcare System (VAGLAHS) has developed a program that shows promise for motivating HF patients to continue to take their medications as prescribed.

The VA cares for more than 210,000 veterans with heart failure, making development of programs that maximize treatment effectiveness a high priority. Multiple agents, including angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), beta-blockers (BBs) and aldosterone antagonists (AAs), reduce heart failure-associated hospitalizations, morbidity and mortality. No matter how efficacious a medication, though, it will not work for a patient who does not take it—which would include 40% to 60% of heart failure patients.

The VAGLAHS established the Heart Failure Post-Discharge Management Clinic in 2010 to supplement the efforts of the system’s cardiomyopathy clinic. The post-discharge clinic works with all patients with heart failure who are discharged from inpatient care to help them transition to outpatient care.

“We started the clinic in 2010 with the goal of reducing HF readmission for patients admitted with HF as their primary diagnosis,” recounted Freny Mody, MD, director of the Advanced Heart Failure Program and the Preventive Cardiology Program at VAGLAHS.

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