Artículo
Care bundle to reduce readmission in patients with heart failure: a modified Delphi consensus panel in Argentina
Roberti, Javier Eugenio
; Vita, Tomás; Piastrella, Jimena; Porley, Carlos; Pereyra, Lisandro; Diez, Mirta; Renedo, Florencia; Fairman, Enrique; Fernández, Alberto; Thierer, Jorge; Garcia Elorrio, Ezequiel
Fecha de publicación:
12/2020
Editorial:
BMJ Publishing Group
Revista:
BMJ Open
e-ISSN:
2044-6055
Idioma:
Inglés
Tipo de recurso:
Artículo publicado
Clasificación temática:
Resumen
Objectives The aim of this study was to develop consensus among Argentine cardiologists on a care bundle to reduce readmissions of patients with heart failure (HF). Setting Hospitals and cardiology clinics in Argentina that provide in-hospital care for patients with HF. Participants Twenty-four cardiology experts participated in the two online rounds and 18 (75%) of them participated in the third-round meeting. Methods This study used a mixed-method design; it was conducted between August 2019 and January 2020. The development of a care bundle (a set of evidence-based interventions applied to improve clinical outcomes) involved three phases: (1) a literature review to define the list of interventions to be evaluated; (2) a modified Delphi panel to select interventions for the bundle and (3) definition of the HF care bundle. Also, the process included three rounds of scoring. Results Twenty-six interventions were evaluated. The interventions in the final bundle covered four categories: medication, continuum of care, lifestyle habits, predischarge tests. These were: medication: beta-blockers, angiotensin receptor neprilysin inhibitors or ACE-inhibitors, furosemide and antimineralocorticoids; continuum of care: follow-up appointment, daily weight monitoring; lifestyle habits: smoking cessation counselling and low-sodium diet; predischarge tests: renal function, ionogram, blood pressure control, echocardiogram and determination of decompensating cause. Conclusion Following a systematic mixed-method approach, we have developed a care bundle of interventions that could decrease readmission of patients with HF. The application of this bundle could contribute to scale evidence-based interventions.
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Citación
Roberti, Javier Eugenio; Vita, Tomás; Piastrella, Jimena; Porley, Carlos; Pereyra, Lisandro; et al.; Care bundle to reduce readmission in patients with heart failure: a modified Delphi consensus panel in Argentina; BMJ Publishing Group; BMJ Open; 10; 12; 12-2020; 1-7
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