Primary Outcome Measures:
- Process-of-care composite score assessed at baseline, at 6 months for effectiveness of the intervention, and at 12 months for sustainability of the effect.
The score includes assessment of:
- ACE-inhibitor use unless contraindicated,ACE-inhibitor dosage is at >50% of clinical trial target dose,Beta-blocker use unless contraindicated.
- Each component of the score will be given one point.
Secondary Outcome Measures:
- Disease specific quality of life (QOL)with Minnessota Living with Heart Failure.
- NYHA functional class.
- Other outcomes
- All-cause hospitalization defined as > 24-hour hospital stay including the time spent in the emergency room.
- Hospitalizations for HF: > 24-hour hospital stay including the time spent in the emergency room with clinical evidence of HF including at least one of
the following: increased dyspnea on exertion, orthopnea, nocturnal dyspnea, elevated jugular venous
- Emergency room visits for deterioration of HF requiring IV or additional PO diuretics: <24-hour stay in hospital/emergency room with clinical evidence
of HF.
- Referral to Hamilton Health Sciences HF clinic or other institution.
- Quality adjusted survival
- Overall costs
Cluster randomized clinical trial (family physician is cluster) evaluating a primary care based heart failure management strategy
Purpose
