Heart failure & cardiomyopathies
Cost-Effectiveness of Outpatient Adherence to Recommendations for Monitoring of Patients Hospitalized for Heart Failure
Study context
- Population
- Residents of Lombardy, Marche, Lazio and Sicily newly hospitalised for HF (any stage and NYHA class) in 2014–2015, followed up until 2019
- Participants
- 41,406 residents
- Exposure
- Adherent vs Non-adherent
- Outcome
- Composite of:
- CV hospital admissions and all-cause mortality (restricted mean survival time and Cox hazard)
- Healthcare costs
- Follow-up
- 5 years
Methodological detailspopulation-based, 4 Italian regions
- Population-based
- 4 Italian regions
Main finding
As reported in the abstract
Composite outcome (CV admissions and all-cause mortality), adherent vs non-adherent
Reduced risk
- Echocardiograms (ECCs); delay 1.6 months
- 9% (95% CI 2–14%)
- RAS inhibitors; delay 1.9 months
- 11% (CI 7–14%)
- Beta-blockers; delay 1.6 months
- 8% (CI 5–11%)
- Mineralocorticoid receptor antagonists (MRAs); delay 0.6 months
- 4% (CI −1-8%)
Observational data: associations, not effects.
Further findings
Adherence rates in cohort · first year after discharge
- RAS inhibitors
- 64%
- Beta-blockers
- 57%
- MRAs
- 62%
- ECCs
- 20%
Average annual healthcare cost, adherent vs non-adherent
- RAS inhibitors: lower cost per year
- €262
- Beta-blockers: lower cost per year
- €92
- MRAs: lower cost per year
- €571
- ECC: higher cost per year
- €511
Delay in composite outcome and cost saving (bootstrap, 1000 replications)
- RAS inhibitors
- 98%
- Beta-blockers
- 84%
- MRAs
- 93%
Original publication
Cost-Effectiveness of Outpatient Adherence to Recommendations for Monitoring of Patients Hospitalized for Heart Failure. ESC Heart Fail. Published 9 May 2024. doi:10.
Summarised from the published abstract; every number is checked against it