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Continuity And Utilization Of Health And Community Care In Elderly Patients With Heart Failure Before And After Hospitalization, Emma Säfström, Tiny Jaarsma, Anna Strömberg Jan 2018

Continuity And Utilization Of Health And Community Care In Elderly Patients With Heart Failure Before And After Hospitalization, Emma Säfström, Tiny Jaarsma, Anna Strömberg

Faculty of Health Sciences Publications

Background: The period after hospitalization due to deteriorated heart failure (HF) is characterized as a time of high generalized risk. The transition from hospital to home is often problematic due to insufficient coordination of care, leading to a fragmentation of care rather than a seamless continuum of care. The aim was to describe health and community care utilization prior to and 30 days after hospitalization, and the continuity of care in patients hospitalized due to de novo or deteriorated HF from the patients’ perspective and from a medical chart review. Methods: This was a cross-sectional study with consecutive inclusion of ...


Effect Of Sacubitril/Valsartan On Recurrent Events In The Prospective Comparison Of Arni With Acei To Determine Impact On Global Mortality And Morbidity In Heart Failure Trial (Paradigm-Hf), Ulrik M. Mogensen, Jianjian Gong, Pardeep Jhund, Li Shen, Lars Kober, Akshay S. Desai, Martin P. Lefkowitz, Milton Packer, Jean L. Rouleau, Scott Solomon, Brian L. Claggett, Karl Sweberg, Michael R. Zile, Guenr Mueller-Velten, John Mcmurray Jan 2018

Effect Of Sacubitril/Valsartan On Recurrent Events In The Prospective Comparison Of Arni With Acei To Determine Impact On Global Mortality And Morbidity In Heart Failure Trial (Paradigm-Hf), Ulrik M. Mogensen, Jianjian Gong, Pardeep Jhund, Li Shen, Lars Kober, Akshay S. Desai, Martin P. Lefkowitz, Milton Packer, Jean L. Rouleau, Scott Solomon, Brian L. Claggett, Karl Sweberg, Michael R. Zile, Guenr Mueller-Velten, John Mcmurray

Faculty of Health Sciences Publications

Aims
Recurrent hospitalizations are a major part of the disease burden in heart failure (HF), but conventional analyses consider only the first event. We compared the effect of sacubitril/valsartan vs. enalapril on recurrent events, incorporating all HF hospitalizations and cardiovascular (CV) deaths in PARADIGM‐HF, using a variety of statistical approaches advocated for this type of analysis.
Methods and results
In PARADIGM‐HF, a total of 8399 patients were randomized and followed for a median of 27 months. We applied various recurrent event analyses, including a negative binomial model, the Wei, Lin and Weissfeld (WLW), and Lin, Wei, Ying ...


Importance Of Clinical Worsening Of Heart Failure Treated In The Outpatient Setting: Evidence From The Prospective Comparison Of Arni With Acei To Determine Impact On Global Mortality And Morbidity In Heart Failure Trial (Paradigm-Hf), Naoki Okumura, Pardeep Jhund, Jianjian Gong, Martin P. Lefkowitz, Adel R. Rizkala, Jean L. Rouleau, Victor C. Shi, Karl Swedberg, Michael R. Zile, Scott Solomon, Milton Packer, John Mcmurray Jan 2016

Importance Of Clinical Worsening Of Heart Failure Treated In The Outpatient Setting: Evidence From The Prospective Comparison Of Arni With Acei To Determine Impact On Global Mortality And Morbidity In Heart Failure Trial (Paradigm-Hf), Naoki Okumura, Pardeep Jhund, Jianjian Gong, Martin P. Lefkowitz, Adel R. Rizkala, Jean L. Rouleau, Victor C. Shi, Karl Swedberg, Michael R. Zile, Scott Solomon, Milton Packer, John Mcmurray

Faculty of Health Sciences Publications

Many episodes of worsening of heart failure (HF) are treated by increasing oral therapy or temporary intravenous treatment in the community or emergency department (ED), without hospital admission. We studied the frequency and prognostic importance of these episodes of worsening in the Prospective Comparison of ARNI (angiotensin-receptor-neprilysin inhibitor) with ACEI (angiotensin-converting enzyme inhibitor) to Determine Impact on Global Mortality and Morbidity in Heart Failure Trial (PARADIGM-HF).


Influence Of Sacubitril/Valsartan (Lcz696) On 30-Day Readmission After Heart Failure Hospitalization, Akshay S. Desai, Brian L. Claggett, Milton Packer, Michael R. Zile, Jean L. Rouleau, Karl Sweberg, Victor Shi, Martin Lefkowitz, Randall Starling, John Teerlink, John J.V. Mcmurray, Scott D. Solomon Jan 2016

Influence Of Sacubitril/Valsartan (Lcz696) On 30-Day Readmission After Heart Failure Hospitalization, Akshay S. Desai, Brian L. Claggett, Milton Packer, Michael R. Zile, Jean L. Rouleau, Karl Sweberg, Victor Shi, Martin Lefkowitz, Randall Starling, John Teerlink, John J.V. Mcmurray, Scott D. Solomon

Faculty of Health Sciences Publications

BACKGROUND Patients with heart failure (HF) are at high risk for hospital readmission in the first 30 days following HF hospitalization. OBJECTIVES This study sought to determine if treatment with sacubitril/valsartan (LCZ696) reduces rates of hospital readmission at 30-days following HF hospitalization compared with enalapril. METHODS We assessed the risk of 30-day readmission for any cause following investigator-reported hospitalizations for HF in the PARADIGM-HF trial, which randomized 8,399 participants with HF and reduced ejection fraction to treatment with LCZ696 or enalapril. RESULTS Accounting for multiple hospitalizations per patient, there were 2,383 investigator-reported HF hospitalizations, of which 1 ...


International Geographic Variation In Event Rates In Trials Of Heart Failure With Preserved And Reduced Ejection Fraction, Søren L. Kristensen, Lars Kober, Pardeep Jhund, Scott Solomon, John Kjekshus, Robert Mckelvie, Michael R. Zile, Christopher B. Granger, John Wikstrand, Michel Komajda, Peter E. Carson, Marc A. Pfeffer, Karl Swedberg, Hans Wedel, Salim Yusuf, John Mcmurray Jan 2015

International Geographic Variation In Event Rates In Trials Of Heart Failure With Preserved And Reduced Ejection Fraction, Søren L. Kristensen, Lars Kober, Pardeep Jhund, Scott Solomon, John Kjekshus, Robert Mckelvie, Michael R. Zile, Christopher B. Granger, John Wikstrand, Michel Komajda, Peter E. Carson, Marc A. Pfeffer, Karl Swedberg, Hans Wedel, Salim Yusuf, John Mcmurray

Faculty of Health Sciences Publications

International geographic differences in outcomes may exist for clinical trials of heart failure and reduced ejection fraction (HF-REF), but there are few data for those with preserved ejection fraction )HF-PEF)


Evaluating The Effects Of Increasing Physical Activity To Optimize Rehabilitation Outcomes In Hospitalized Older Adults (Move Trial): Study Protocol For A Randomized Controlled Trial, Catherine M. Said, Meg E. Morris, Jennifer L. Mcginley, Cassandra Szoeke, Barbara Workman, Danny Liew, Keith David Hill, Michael Clifford Woodward, Joanne E. Wittwer, Leonid Churilov, Cameron Ventura, Julie Bernhardt Jan 2015

Evaluating The Effects Of Increasing Physical Activity To Optimize Rehabilitation Outcomes In Hospitalized Older Adults (Move Trial): Study Protocol For A Randomized Controlled Trial, Catherine M. Said, Meg E. Morris, Jennifer L. Mcginley, Cassandra Szoeke, Barbara Workman, Danny Liew, Keith David Hill, Michael Clifford Woodward, Joanne E. Wittwer, Leonid Churilov, Cameron Ventura, Julie Bernhardt

Faculty of Health Sciences Publications

Background: Older adults who have received inpatient rehabilitation often have significant mobility disability at discharge. Physical activity levels in rehabilitation are also low. It is hypothesized that providing increased physical activity to older people receiving hospital-based rehabilitation will lead to better mobility outcomes at discharge. Methods/Design: A single blind, parallel-group, multisite randomized controlled trial with blinded assessment of outcome and intention-to-treat analysis. The cost effectiveness of the intervention will also be examined. Older people ( age > 60 years ) undergoing inpatient rehabilitation to improve mobility will be recruited from geriatric rehabilitation units at two Australian hospitals. A computer-generated blocked stratified randomization ...


Influence Of Hospitalization For Cardiovascular Versus Noncardiovascular Reasons On Subsequent Mortality In Patients With Chronic Heart Failure Across The Spectrum Of Ejection Fraction, Akshay S. Desai, Brian L. Claggett, Marc A. Pfeffer, Natalie Bello, Peter Finn, Christopher B. Granger, John Mcmurray, Stuart J. Pocock, Karl Swedberg, Salim Yusuf, Scott Solomon Jan 2014

Influence Of Hospitalization For Cardiovascular Versus Noncardiovascular Reasons On Subsequent Mortality In Patients With Chronic Heart Failure Across The Spectrum Of Ejection Fraction, Akshay S. Desai, Brian L. Claggett, Marc A. Pfeffer, Natalie Bello, Peter Finn, Christopher B. Granger, John Mcmurray, Stuart J. Pocock, Karl Swedberg, Salim Yusuf, Scott Solomon

Faculty of Health Sciences Publications

Noncardiovascular (non-CV) comorbidities may contribute to hospitalizations in patients with heart failure (HF). We examined the incidence of mortality following hospitalization for cardiovascular (CV) versus non-CV reasons in the Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) Program.


Risk Prediction In Patients With Heart Failure: A Systematic Review And Analysis, Kazem Rahimi, Derrick A. Bennett, Nathalie Conrad, Timothy M. Williams, Joyee Basu, Jeremy Dwight, Mark Woodward, Anushka Patel, John Mcmurray, Stephen Macmahon Jan 2014

Risk Prediction In Patients With Heart Failure: A Systematic Review And Analysis, Kazem Rahimi, Derrick A. Bennett, Nathalie Conrad, Timothy M. Williams, Joyee Basu, Jeremy Dwight, Mark Woodward, Anushka Patel, John Mcmurray, Stephen Macmahon

Faculty of Health Sciences Publications

Objectives This study sought to review the literature for risk prediction models in patients with heart failure and to identify the most consistently reported independent predictors of risk across models. Background Risk assessment provides information about patient prognosis, guides decision making about the type and intensity of care, and enables better understanding of provider performance. Methods MEDLINE and EMBASE were searched from January 1995 to March 2013, followed by hand searches of the retrieved reference lists. Studies were eligible if they reported at least 1 multivariable model for risk prediction of death, hospitalization, or both in patients with heart failure ...


Influence Of Previous Heart Failure Hospitalization On Cardiovascular Events In Patients With Reduced And Preserved Ejection Fraction, Natalie A. Bello, Brian L. Claggett, Akshay S. Desai, John Mcmurray, Christopher B. Granger, Salim Yusuf, Karl Swedberg, Marc A. Pfeffer, Scott Solomon Jan 2014

Influence Of Previous Heart Failure Hospitalization On Cardiovascular Events In Patients With Reduced And Preserved Ejection Fraction, Natalie A. Bello, Brian L. Claggett, Akshay S. Desai, John Mcmurray, Christopher B. Granger, Salim Yusuf, Karl Swedberg, Marc A. Pfeffer, Scott Solomon

Faculty of Health Sciences Publications

Hospitalization for acute heart failure (HF) is associated with high rates of subsequent mortality and readmission. We assessed the influence of the time interval between previous HF hospitalization and randomization in the Candesartan in Heart failure: Reduction in Mortality and morbidity (CHARM) trials on clinical outcomes in patients with both reduced and preserved ejection fraction.


Do Countries Or Hospitals With Longer Hospital Stays For Acute Heart Failure Have Lower Readmission Rates? : Findings From Ascend-Hf, Zubin J. Eapen, Shelby D. Reed, Yanhong Li, Robb D. Kociol, P W. Armstrong, Randall C. Starling, John Mcmurray, Barry M. Massie, Karl Swedberg, Justin A. Ezekowitz, Gregg C. Fonarow, John R. Teerlink, Marco Metra, David J. Whellan, Christopher M. O'Connor, Robert M. Califf, Adrian F. Hernandez Jan 2013

Do Countries Or Hospitals With Longer Hospital Stays For Acute Heart Failure Have Lower Readmission Rates? : Findings From Ascend-Hf, Zubin J. Eapen, Shelby D. Reed, Yanhong Li, Robb D. Kociol, P W. Armstrong, Randall C. Starling, John Mcmurray, Barry M. Massie, Karl Swedberg, Justin A. Ezekowitz, Gregg C. Fonarow, John R. Teerlink, Marco Metra, David J. Whellan, Christopher M. O'Connor, Robert M. Califf, Adrian F. Hernandez

Faculty of Health Sciences Publications

Hospital readmission is an important clinical outcome of patients with heart failure. Its relation to length of stay for the initial hospitalization is not clear.


Electronically Monitored Medication Adherence Predicts Hospitalization In Heart Failure Patients, Barbara Riegel, George J. Knafl Jan 2013

Electronically Monitored Medication Adherence Predicts Hospitalization In Heart Failure Patients, Barbara Riegel, George J. Knafl

Faculty of Health Sciences Publications

Background: Hospitalization contributes enormously to health care costs associated with heart failure. Many investigators have attempted to predict hospitalization in these patients. None of these models has been highly effective in prediction, suggesting that important risk factors remain unidentified. Purpose: To assess prospectively collected medication adherence, objectively measured by the Medication Event Monitoring System, as a predictor of hospitalization in heart failure patients. Materials and methods: We used recently developed adaptive modeling methods to describe patterns of medication adherence in a sample of heart failure patients, and tested the hypothesis that poor medication adherence as determined by adaptive methods was ...


The Epidemiology Of The First Wave Of H1n1 Influenza Pandemic In Australia: A Population-Based Study, Julie A. Pasco, Geoffrey Charles Nicholson, Sharon L. Brennan, Kathy E. Bennett, Amelia Grace Dobbins, Eugene Athan Jan 2012

The Epidemiology Of The First Wave Of H1n1 Influenza Pandemic In Australia: A Population-Based Study, Julie A. Pasco, Geoffrey Charles Nicholson, Sharon L. Brennan, Kathy E. Bennett, Amelia Grace Dobbins, Eugene Athan

Faculty of Health Sciences Publications

Objectives: Following the recent H1N1 influenza pandemic we were able to describe seropositivity in a repre-sentative sample of adults prior to the availability of a specific vaccine. Methods: This cross-sectional serological study is set in the Barwon Statistical Division, Australia. Blood samples were collected from September 2009 through to May 2010, from 1184 individuals (569 men, 615 women; median age 61.7 years), randomly selected from electoral rolls. Serum was analysed for specific H1N1 immunity using a haemagglutina-tion inhibition test. A self-report provided information about symptoms, demographics and healthcare. Associations be-tween H1N1 infection, gender, households and occupation were determined using ...


Eplerenone In Patients With Systolic Heart Failure And Mild Symptoms: Analysis Of Repeat Hospitalizations, Jennifer K. Rogers, John Mcmurray, Stuart J. Pocock, Faiez Zannad, Henry Krum, Dirk J. Van Veldhuisen, Karl Swedberg, Harry Shi, John Vincent, Bertram Pitt Jan 2012

Eplerenone In Patients With Systolic Heart Failure And Mild Symptoms: Analysis Of Repeat Hospitalizations, Jennifer K. Rogers, John Mcmurray, Stuart J. Pocock, Faiez Zannad, Henry Krum, Dirk J. Van Veldhuisen, Karl Swedberg, Harry Shi, John Vincent, Bertram Pitt

Faculty of Health Sciences Publications

Eplerenone is known to reduce time to first hospitalization for heart failure or cardiovascular death in patients with heart failure and mild symptoms. In chronic diseases such as heart failure, characterized by repeat hospitalizations, analyzing all heart failure hospitalizations, not just the first, should give a more complete picture of treatment benefits.