Wayne State to lead Detroit site in new national heart failure study

DETROIT The Wayne State University School of Medicine and Detroit Receiving Hospital of the Detroit Medical Center will serve as a site for a national study that will develop new guidelines for patients released from the emergency room after treatment for suspected acute heart failure symptoms.

Phillip Levy, M.D., M.P.H., professor of Emergency Medicine and associate chair for Research in the Department of Emergency Medicine, will direct the enrollment and engagement core for the entire study, as well as serve principal investigator for the Detroit site.

The overall three-year project, funded with a $2,083,575 grant from the Patient-Centered Outcomes Research Institute, will be overseen by Sean Collins, M.D., of Vanderbilt University.

Dr. Levy, who also serves as the director of the WSU Clinical Research Center – where study patients will follow up – will enroll participants through the emergency room at Detroit Receiving Hospital. He hopes to enroll 200 of the anticipated 700 study participants.

The study, “Get with the Guidelines in ED Patients with Heart Failure,” will seek to address disparities in the discharge follow-up information provided to two groups – patients with suspected heart failure released after hospitalization, and those seen and released from emergency rooms.

More than 1 million people annually are hospitalized for acute heart failure in the United States and more than 80 percent of those patients are initially treated in emergency rooms. More than 200,000 patients, however, are diagnosed as not serious enough for immediate hospitalization and are discharged from emergency rooms. The study’s investigators said their preliminary work demonstrates that the patients going home from the emergency room are many times unsure of their next steps, the medications they should take and when they should schedule follow-up appointments.

Patients who are hospitalized, in contrast, undergo pre-discharge consultations explaining this information, and in addition, often receive it in writing. Implementing similar procedures with emergency room patients has never been examined.

The investigators will implement the American Heart Association’s Get With The Guidelines–Heart Failure program at the study sites. The program is a national initiative of the AHA designed to improve care through consistent adherence to treatment protocols. According to the association, numerous studies have demonstrated the program’s success, including reductions in 30-day readmissions for acute heart failure.

The study sites will place a “transition nurse coordinator” in emergency rooms to implement the Get With The Guideline protocols and educate patients before they are discharged. The researchers will examine whether the practice reduces disparities in emergency room and hospital revisits and deaths in patients discharged from emergency rooms. They also will consider improved outcomes in the patients’ quality of life, heart failure knowledge and overall satisfaction.

Study participants will be followed through social media and semiannual meetings to determine how to improve the study process. The study is being conducted in coordination with the AHA and the results will be disseminated through its quality improvement channels.


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