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An abstract of the study "Poznan multidisciplinary heart failure care: 6 months experience," by M. Wierzchowiecki and colleagues, is presented.

Among the modifiable risk factors smoking has the most impact on cardiovascular mortality. Among patients with cardiovascular disease benefits of quitting smoking outweigh those associated with commonly prescribed drugs. Hospitalization in the ward seems to be a good time to motivate the patient to take this step. In our paper we present the effectiveness of different methods to achieve this goal.

Unlabelled: In the last years multidisciplinary care (MDC) of patients with chronic heart failure has proved to be effective. Because of specificity of the medical care organization in different countries the outcome of the programs may be various. The aim of this study was to evaluate the effect of MDC on patients' survival, hospitalization rate and stay., Material and Methods: 129 chronic heart failure patients admitted to Department of Cardiology were randomized to MDC or routine care (RC) groups. All patients were referred to their primary care physicians. In 64 patients from MDC group, aged 68 +/- 10.5 years, a follow-up was performed on 14 day, 3 and 6 months, on the basis of heart failure clinic, by cardiologist, heart failure nurse, psychologist and physiotherapist. Patients received heart failure nurse and cardiologist broad educational program systematically. Every day heart failure nurse telephone counseling and home-based interventions were also available to the patients. 65 patients from RC group, aged 72 +/- 11.5 years, were referred only to their primary care physicians., Results: There was the lower duration of hospitalization in MDC than in RC group (8.3 +/- 5.31 vs 13.5 +/- 6.99 days; p < 0.05). A tendency to the lower duration of heart failure hospitalization and frequency of total and heart failure hospitalization in MDC group was observed (9.8 +/- 5.46 vs 12.1 +/- 6.23 days, 18.8 vs 25.0, and 12.5 vs 16.9% respectively). No significant differences were found between MDC and RC total and heart failure mortality (15.6 vs 16.9%, and 10.9 vs 12.3%, respectively)., Conclusion: Six months multidisciplinary care of chronic heart failure patients has appeared more efficient than routine primary care.

Introduction: Recent trials have demonstrated the effectiveness of multidisciplinary care (MDC) for patients with chronic heart failure (CHF). However, results of the assessment of different programmes in individual countries could be different because of local specificities of health care systems., Aim: We sought to determine whether MDC for patients with CHF has an influence on mortality, rate of rehospitalisation, quality of life (QoL) and self-care (SC) during a one-year study period., Methods: 160 patients with CHF treated in our unit were randomly assigned to receive either MDC or routine care (RC). Patients from the MDC group (n=80; mean age 67+/-10.2 years) attended follow-up visits at the heart failure clinic after 14 days and 3, 6, 9 and 12 months after discharge. They were cared for by a team which consisted of a cardiologist, a heart failure nurse (HF nurse), a psychologist and a physiotherapist. This group of patients received comprehensive education from the HF nurse and the cardiologist. Telephone counselling and home-based interventions by the HF nurse were also available daily. Patients from the RC group (n=80, mean age 69.5+/-10.7 years) were cared for by their primary care physician only. In both groups QoL and SC scores were calculated based on a 21 and 12-item questionnaire completed by the patients at discharge and after one year., Results: After one-year follow-up the two groups did not differ in terms of either total and HF mortality or number of sudden deaths. In the MDC group when compared to the RC group we observed a significant decrease in the total number of hospital readmissions (by 37%, p <0.05), a decrease in hospital admissions due to HF (by 48%; p <0.05) and decreased length of stay during both all-cause readmissions and those due to HF (p <0.05). After one year of follow-up both QoL and SC scores were significantly lower in the MDC group than in the RC group (p <0.001), indicating improved QoL in the MDC group., Conclusions: The one-year multidisciplinary care programme for patients with chronic heart failure in Poznań demonstrated significant improvement of treatment results in terms of frequency of readmissions and length of hospital stay as well as improved Qol. A tendency to decreased total and heart failure related mortality and decreased number of sudden deaths was also observed.