Baseline Characteristics, Management and Outcomes of Patients With Heart Failure and Preserved Ejection Fraction in a Nurse Facilitated Care Model

Introduction: Current clinical guidelines recommend that patients with heart failure (HF) receive multidisciplinary care at nurse-led HF clinics both for optimisation of medical therapies and to reduce preventable readmissions. Methods: We present the biological and clinical characteristics of patients with HF and preserved ejection fraction (HFPEF) and the clinical outcomes achieved (all-cause mortality [ACM] or HF hospitalisation) within the GenesisCare Heart Failure Management Clinics (GC-HFMC). GC-HFMCs are a HF specialist led, nurse-facilitated model providing comprehensive pharmacological and non-pharmacological management, HF education and a HF nurse support service. Results: The cohort (n = 297) was predominantly female (62%) with mean age 79 ± 10 years, median LVEF of 60% (IQR 55,65) and NYHA class II (56%) and III (34%). Community referrals accounted for 80% of patients, with 20% referred post hospitalisation. There was a high incidence of comorbidities, such as hypertension (83%), dyslipidaemia (65%), arrhythmia (64%), diabetes (34%), chronic renal failure (45%), airway disease (33%) and anaemia (31%). The STOP-Bang score indicated 76% of patients were high risk for obstructive sleep apnoea (OSA) but only 15% had a known OSA diagnosis. Medications included BB (57%), ACEI/ARB (59%) and diuretics (81%). Patient satisfaction with care was high (net promoter score >80%). At one year, the combined end point of ACM or HF hospitalisation occurred in 11.1%, and ACM occurred in 6.4%. Conclusions: The findings demonstrate the impact of nurse facilitated GC-HFMCs in providing quality care and delivering low hospitalisation and mortality rates.