This is a controlled, randomized, open-label, multicentric study evaluating the value of coordinated medico-pharmaceutical management compared to standard management in patients with heart failure. The aim of this study is to evaluate the impact of these optimized activities on the re-hospitalization of the patient with cardiac insufficiency for a disease-related event within three months of the initial hospitalization.
Heart failure (FH) is a public health problem with an estimated prevalence of about 1.5% in developed countries. In 2013, the number of patients hospitalized in France for heart failure amounted to 165 231 and 20% of them were re-hospitalized at least once for the same reason during this year. Several factors contribute to the occurrence of cardiac decompensation (DC) : some modifiable (age, severity of IC, etiology ...) and others modifiable, such as therapeutics. Various elements could reduce the frequency of re-hospitalizations and the mortality due to this disease : * a better knowledge of treatments by patients and consequently a better therapeutic compliance * a better knowledge of the factors and signs of DC (low-sodium diet, weighing...) * a better implementation of prescribing recommendations : less than 50% of patients have optimal treatment compared to ESC recommendations * a better communication at the transition points of the patient pathway. The creation of a binomial cardiologist-clinical pharmacist during hospitalization and the maintenance of this optimized multidisciplinary follow-up within 3 months post-hospitalization is a proposal to intervene on these factors. Indeed, the clinical pharmacist (present in the care unit) works in collaboration with the medical and paramedical teams and can improve the care of patients. In the experimental group, a specific multidisciplinary consultation is planned for one month after the end of the hospitalization. A 3-month follow-up visit will be carried out by phone call to meet the criteria for readmission, mortality, quality of life, adherence and persistence of treatments.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
248
Reinforced multidisciplinary follow-up
University Hospital of Montpellier Cardiology departments oh the Montpellier, Nîmes and Toulouse University Hospitals
Montpellier, Occitanie, France
RECRUITINGRehospitalisation for heart failure
At least one rehospitalisation with heart failure related cause
Time frame: Call at 3 months after hospitalisation discharge
Prescriptions conformity rates compared to heart failure recommendations edited by the European Society of Cardiology in 2016
Evaluated by a pharmacist
Time frame: At hospitalisation discharge (Day 0)
Prescriptions conformity rates compared to heart failure recommendations edited by the European Society of Cardiology in 2016
Evaluated by a pharmacist
Time frame: Call at 3 months after hospitalisation discharge
Compliance level
Evaluated by the " Girerd medication adherence questionnaire " The " Girerd medication adherence questionnaire " contains 6 questions which answers are " yes " or " no ". The number of " yes " responses permits to evaluate the level of the patient medication adherence as following : 0 yes : good compliance 1 or 2 yes : minor non compliance 3 or more yes : non compliance
Time frame: At hospitalisation discharge (Day 0)
Compliance level
Evaluated by the "Girerd medication adherence questionnaire" Evaluated by the " Girerd medication adherence questionnaire " The " Girerd medication adherence questionnaire " contains 6 questions which answers are " yes " or " no ". The number of " yes " responses permits to evaluate the level of the patient medication adherence as following : 0 yes : good compliance 1 or 2 yes : minor non compliance 3 or more yes : non compliance
Time frame: At 1 month after hospitalisation discharge for the experimental group only
Compliance level
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Evaluated by the "Girerd medication adherence questionnaire" Evaluated by the " Girerd medication adherence questionnaire " The " Girerd medication adherence questionnaire " contains 6 questions which answers are " yes " or " no ". The number of " yes " responses permits to evaluate the level of the patient medication adherence as following : 0 yes : good compliance 1 or 2 yes : minor non compliance 3 or more yes : non compliance
Time frame: Call at 3 months after hospitalisation discharge
Treatment persistence rates
Evaluated by a pharmacist
Time frame: Call at 3 months after hospitalisation discharge
Death rate
Evaluated by a pharmacist
Time frame: Call at 3 months after hospitalisation discharge
Time before death
Evaluated by a pharmacist
Time frame: Call at 3 months after hospitalisation discharge
Time of occurrence of a potential rehospitalisation related to the disease
Evaluated by a pharmacist
Time frame: Call at 3 months after hospitalisation discharge
Quality of life score
Evaluated by the Minnesota Living with Heart Failure Questionnaire the Minnesota Living with Heart Failure Questionnaire contains 21 questions. Each of the 21 questions ask the patients to indicate how much a possible effect of heart failure have affected their ability to live as wanted during the past month using a scale from 0 (not present or no effect), 1 (very little), 2, 3, 4, or 5 (very much).The measurement of heart failure severity is assessed by summing the responses that ranges from 0 to 105.
Time frame: Call at 3 months after hospitalisation discharge
Satisfaction of the patient
Evaluated by Likert scale This questionnaire indicates the degree of patient satisfaction using 9 questions which explore the improvement of patient behavior concerning disease and treatment. The measurement of satisfaction is assessed by summing the responses that range from 9 (unsatisfied) to 36 (very satisfied)
Time frame: Call at 3 months after hospitalisation discharge
Satisfaction of health professionals
Evaluated by Likert scale (only for interventional arm) This questionnaire indicates the degree of health professional satisfaction using 6 questions which explore the improvement of transition between hospital to community and comprehension of therapeutic optimization. The measurement of satisfaction is assessed by summing the responses that range from 6 (unsatisfied) to 24 (very satisfied)
Time frame: online questionnaire at 3 months after hospitalisation discharge
Incremental cost-effectiveness ratio
Time frame: 3 months after hospitalisation discharge