The Duke Heart Failure Program is made up of cardiologists, nurse practitioners, nurse specialists, clinical pharmacists, as well as nutritionists and social workers. One of the most important contributing factors in reducing hospitalizations, Whellan said, was the marked increase in the use of beta-blockers, from 52 percent to 76 percent. Because beta-blockers can slow heart rate and decrease the ability of heart muscle to contract, many physicians will not prescribe these drugs for their patients. However, beta-blockers have been shown to improve the function of the left ventricle, the main chamber that pumps blood to the body. A program like this can help to demonstrate how new types of medication can be incorporated into an overall treatment plan and improve the quality of life for patients.
Patients clearly are more comfortable in familiar surroundings.
The study also found that use of ACE inhibitors, which relax blood vessels and allow blood to be pumped with less effort, remained virtually unchanged, and that may not be in the best interest of their patients. What we did find, however, was that in many cases the dosages were below the target dose. For example, some physicians stop prescribing if their patient's blood pressure rises. However, we have a lot of experience in this area, and we feel confident that we can be aggressive in the use of ACE inhibitors while keeping a close eye on the patient. Since CHF patients commonly take up to a dozen medications, it is important, Whellan said, that their care be closely monitored and supervised.