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A review of Integrated Heart Failure Care

MacInnes, Julie, Williams, Liz (2018) A review of Integrated Heart Failure Care. Primary Health Care Research and Development, . ISSN 1463-4236. E-ISSN 1477-1128. (doi:10.1017/S1463423618000312)

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https://doi.org/10.1017/S1463423618000312

Abstract

Abstract Aim The aim of this integrative review is to determine the effectiveness of integrated heart failure (HF) care in terms of patient-, service- and resource-related outcomes, and to determine what model or characteristics of integrated care work best, for whom and in what contexts. Background Integration of health and social care services is a significant driver in the development of better and more cost-effective health and social care systems in Europe and developed countries. As high users of health and social care services, considerable attention has been paid to the care of people with long-term conditions. HF is a progressive, prevalent, and disabling condition, requiring complex management involving multiple health and social care agencies. Methods An integrative review was conducted according to a framework by Whittemore and Knafl (2005). A literature search was undertaken using the databases: Medline, CINAHL, Embase, PsychINFO and the Cochrane Library, using key words of ‘heart failure’ OR ‘cardiac failure’ AND ‘integrated’ OR ‘multidisciplinary’ OR ‘interdisciplinary’ OR ‘multiprofessional’ OR ‘interprofessional’ OR ‘collaborative care’. Application of the inclusion and exclusion criteria resulted in 17 articles being included in the review. Articles were screened and coded for methodological quality according to a 2-point criteria. Data was extracted using a template and analysed thematically. Findings Integrated HF care results in enhanced quality of life (QoL), and improved symptom control and self-management. Reduced admission rates, reduced length of hospital stay, improved prescribing practices and better care co-ordination are also reported. There is more limited evidence for improved efficiency although overall costs may be reduced. Although findings are highly context dependent, key features of integrated HF models are: liaison between primary and secondary care services to facilitate planned discharge, early and medium term follow-up, multidisciplinary patient education and team working including shared professional education, and the development and implementation of comprehensive care pathways.

Item Type: Article
DOI/Identification number: 10.1017/S1463423618000312
Uncontrolled keywords: Heart Failure; Integrated Care; Integrated Review; Primary Care
Subjects: R Medicine > R Medicine (General)
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Julie MacInnes
Date Deposited: 10 Apr 2018 09:43 UTC
Last Modified: 29 May 2019 20:27 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/66676 (The current URI for this page, for reference purposes)
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