Implementation of a multidisciplinary inpatient heart failure service and its association with hospitalized patient outcomes: First experience from the Middle East and North Africa region

• Published in: Heart & lung Vol. 61; pp. 92 - 97
• Main Authors: Manla, Yosef, Ghalib, Hussam H, Badarin, Firas Al, Ferrer, Richard, Lee-St. John, Terrence, Abdalla, Khalid, Soliman, Medhat, Gabra, Guirgis, Bader, Feras
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-09-2023
• Subjects: Africa, Northern - epidemiology; Heart Failure - therapy; Heart failure service; Hospitalization; Humans; Inpatient; Inpatients; Middle East; Middle East - epidemiology; Multidisciplinary; Patient Readmission; Retrospective Studies; Africa, Northern; Middle East; Middle East; HF-MDT; Heart failure service; GDMT; Inpatient; Multidisciplinary; HF; MENA
• ISSN: 0147-9563; 1527-3288
• DOI: 10.1016/j.hrtlng.2023.05.004

•Implementing a multidisciplinary HF team was associated with better adherence to GDMT.•Implementing a multidisciplinary HF team was associated with improved hospital resource utilization.•This study supports broader adoption of multidisciplinary HF teams in hospitals outside the USA/EU.
Multidisciplinary care models have been associated with improved clinical outcomes and an increase in adherence to guideline-directed medical therapy among patients hospitalized with heart failure (HF).
This study aims to evaluate the association between the creation of a multidisciplinary inpatient HF service and patient outcomes at a tertiary care center in the Middle East/ North Africa.
We used electronic health records to retrospectively identify patients hospitalized for acute HF between June-2015 and June-2018. Patients were categorized by whether they were hospitalized before (n = 71) or after (n = 86) the implementation of a multidisciplinary HF team (HF-MDT), starting on 1/1/2017. The groups were compared for optimal use of guideline-directed medical therapy, hospital length of stay, 30-day hospital readmission, and in-hospital mortality.
The creation of the HF-MDT was associated with significantly better adherence to GDMT at discharge (27.5% vs. 55.4%, (OR 3.3, 95% CI [1.65–6.5]), P<0.001), shorter median hospital length of stay (8, IQR [4.8 - 19] vs. 5, IQR [3– 9], P = 0.02) and a reduction in 30-day hospital readmission (26.5% vs. 11%; OR 0.3, 95% CI [0.1–0.8], P = 0.02). However, there was no difference in-hospital mortality (10.5% vs. 3.5%; OR 0.3, 95% CI [0.1–1.2], P = 0.1).
Implementing an HF-MDT in the care of patients hospitalized with HF is associated with better adherence to GDMT on discharge, reduced hospital length of stay, and lower 30-day readmission rates. The current data support the broader adoption of dedicated HF programs in the Middle East to improve outcomes of patients with HF.