Effects of multidisciplinary care in the heart failure clinic of Pranangklao Hospital

Abstract

Its primary objective was to assess the data and outcomes of multidisciplinary treatment within the heart failure clinic at Pranangklao Hospital. The research encompassed a total of 85 patients, with a notable predominance of males at 69.41%. A majority of these patients fell within the age between 30 and 60 years. Moreover, 56.47% of the subjects presented comorbidities, including hypertension (58.82%), diabetes mellitus (37.65%), atrial fibrillation (18.82%), and chronic kidney disease (stage 3-5, 15.29%), with a substantial proportion being smokers (50.59%) and alcohol consumers (51.76%). More than 80% of patients received ACEI (angiotensin-converting enzyme inhibitors), ARBs (angiotensin receptor blockers), and ARNI (Angiotensin Receptor Blocker/Neprilysin Inhibitor). A comparative analysis of pre- and post-treatment data revealed that a higher number of patients achieved treatment goals in alignment with heart failure treatment guidelines. Notable improvements were observed in the utilization of MRA (Mineralocorticoid receptor antagonist), beta-blockers, and SGLT-2 (sodium-glucose co-transporter-2) inhibitors, all of which demonstrated statistical significance (p < 0.001). NYHA (New York Heart Association) functional class evaluations indicated a substantial shift from Class III and IV to Class I and II for nearly all patients, with significant improvements in cardiac performance status noted three months after treatment initiation. Heart failure hospitalization within the subsequent three months was limited to just 3.5% of the participants, and no fatalities occurred within the one-year follow-up. In conclusion, the implementation of multidisciplinary care resulted in more patients receiving the recommended medication dosages, improved disease control, symptom management, and a reduction in disease-related complications. Mortality and hospitalization rates decreased, while clinic performance met the desired benchmarks, enhancing patients' quality of life. The study underscores the importance of healthcare professionals and multidisciplinary teams staying abreast of evolving treatment modalities.