Inpatient initiation of beta-blockade plus nurse management in vulnerable heart failure patients: a randomized study.

Background: Predischarge beta-blocker initiation in hospitalized patients with heart failure due to reduced left ventricular ejection fraction (LVEF) is safe and improves adherence; improved outcomes with this approach have not been demonstrated in a randomized trial. This study compared 6-month rehospitalization rates among patients assigned to predischarge beta-blockade coupled with postdischarge nurse management (intervention) versus usual care.

Methods And Results: We randomized 64 patients with an LVEF View Article and Find Full Text PDF

Comprehensive coronary artery disease care in a safety-net hospital: results of Get With The Guidelines quality improvement initiative.

Background: Adherence to published coronary artery disease (CAD) guidelines is suboptimal, particularly among minorities and the poor. While hospital-based quality-improvement programs may increase the use of evidence-based therapies, little data exist regarding the impact of such programs in sociodemographically disadvantaged (vulnerable) populations. Vulnerable patients in the United States are cared for primarily within the safety-net health system, which comprises urban public hospitals and outpatient community health centers.

Impact of a cardiac risk reduction program in vulnerable patients hospitalized with coronary artery disease.

Study Objective: To increase the use of guideline-based pharmacotherapy in vulnerable patients (ethnic minorities and the poor) with coronary artery disease (CAD) through a nurse-based quality-improvement program.

Design: Retrospective program evaluation.

Setting: Inner-city hospital in Denver, Colorado.