RAndomized Controlled Trial of a Multiple INtervention proGram to Decrease Heart Failure Rehospitalization

RAndomized Controlled Trial of a Multiple INtervention proGram to Decrease Heart Failure Rehospitalization

The prevalence of heart failure (HF) is constantly increasing in France due to the aging of the population, better management of etiological factors and improved treatments (drug / interventional). On the other hand, re-hospitalizations for heart failure continue to increase, exceeding reception capacities and constitute a real challenge for current public health systems. The PRADO system provides administrative support (through a health insurance advisor) in the management of patient appointments with their doctors as well as home visits by a nurse trained in heart failure. Other interventional medical and educational interventions performed during an out-of-hospital consultation guided by a computer platform would help to optimize the care and continuity of care.

The aim of this study is to demonstrate the value of a multiple intervention program in reducing early readmissions for heat failure in patients hospitalized for cardiac decompensation.

This work will create an interventional assistance program to structure the exit consultation in order to optimize treatment, educate patients, ensure the continuity of hospital-city care and improve compliance (reminders) to reduce re-hospitalizations. This program will be carried out by using a computer platform allowing the systematization of output documents and the sending of messages (e-mail / SMS) for making appointments (medical consultations, biologicals sampling) and perfect therapeutic education.

Inclusion Criteria:

• Heart decompensation requiring hospitalization and the use of intravenous diuretic therapy
• Left Ventricular Ejection Fraction ≤ 40%.

Exclusion Criteria:

• Hospitalization for cardiac decompensation leading to an invasive procedure (valve, coronary, etc.).
• Acute reversible cause of heart failure.
• Incurable disease (other than heart failure) or estimated life expectancy of less than one year.
• Patient transferred directly to another department or cardiac rehabilitation center.
• Significant cognitive impairment.
• Patient without cell phone or email.
• Linguistic or psychic refusal or inability to sign the informed consent.
• Current participation in a clinical tria