Including treatment and monitoring of iron deficiency in multidisciplinary and integrated heart failure care

The Germans Trias Hospital in Spain tested a STOP-HF-Clinic service to support people living with heart failure (HF) following hospital discharge, which included screening for and management of iron deficiency. Older and/or frail people hospitalised for HF in the internal medicine or geriatric departments were eligible for the service, which included:

• a follow-up appointment within seven days of discharge with an HF nurse, GP, cardiologist, internist or geriatrician. In this appointment, people were examined for known risk factors of HF exacerbation, including iron deficiency, fluid retention and high levels of natriuretic peptides (hormones produced by the heart)
• a face-to-face educational session with an HF nurse, whom patients could contact thereafter by telephone
• a minimum of three visits for optimisation of medication, including the administration of intravenous iron when needed.

After 30 days, patients were transitioned from the STOP-HF-Clinic service to standard care led by their GP or relevant specialist. An evaluation of the STOP-HF-Clinic service found that around 17% of people were treated with intravenous iron, and that the programme significantly reduced hospital readmissions compared with standard care, which may in part be due to the identification and treatment of iron deficiency in people living with HF.

References

Pacho C, Domingo M, Núñez R, et al. 2017. Early postdischarge STOP-HF-clinic reduces 30-day readmissions in old and frail patients with heart failure. Rev Esp Cardiol (Engl Ed) 70(8): 631-38