Heart failure & cardiomyopathiesRandomised controlled trial
Effect of a Transitional Care Model Following Hospitalization for Heart Failure: 3-Year Outcomes of the Patient-Centered Care Transitions in Heart Failure (PACT-HF) Randomized Controlled Trial
- Randomised controlled trial
- pragmatic
- stepped-wedge cluster
- 10 hospitals
Authors' conclusion
More than 9 of 10 patients hospitalized for HF experienced all-cause death, readmission, or ED visit at 3 years. A transitional care model with services titrated to risk did not improve the composite of these endpoints, likely because there were no major differences in uptake of medical therapies between the groups.
Study context
- Population
- Patients hospitalised for heart failure (HF)
- Participants
- 2,494 patients
- Comparison
- Transitional care model vs usual care
- Primary endpoint
- Composite of:
- All-cause death
- Readmission
- ED visit
- Follow-up
- 3 years
Primary result
As reported in the abstract
Hazard ratio
0.92
95% CI 0.81–1.05
Events by treatment group
Intervention vs Usual care
HR 0.92 (95% CI 0.81–1.05)
Secondary outcomes
| Outcome | Intervention | Usual care | Estimate | |
|---|---|---|---|---|
| ED visits, by sex (subgroup) · women | HR 0.79 (95% CI 0.63–1.00) | |||
| ED visits, by sex (subgroup) · men | HR 0.98 (95% CI 0.80–1.19) | |||
| Uptake of sacubitril/valsartan | 3.3% | 1.5% | relative risk 6.2 (95% CI 1.92–20.06) | |
| 0.050.21520Ratio (log scale) |
- Emergency department (ED) visits, by sex (subgroup): sex-treatment interaction p = 0.23
Components of the primary outcome
- Intervention did not reduce the risk of the component outcomes overall
Uptake of sacubitril/valsartan
- Uptake of other guideline-directed medical therapy no different
Original publication
Effect of a Transitional Care Model Following Hospitalization for Heart Failure: 3-Year Outcomes of the Patient-Centered Care Transitions in Heart Failure (PACT-HF) Randomized Controlled Trial. Eur J Heart Fail. Published 1 February 2024. doi:10.1002/ejhf.3134
Summarised from the published abstract; every number is checked against it