Do Disease Management Programs Really Make a Difference in Heart Failure?

Current national guidelines for the management of chronic heart failure support the use of disease management programs to reduce morbidity and mortality. However, what specific components of — or degree of clinician involvement in — such programs are necessary to produce favorable outcomes have not been identified.

Investigators for the multicenter Coordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure (COACH) trial evaluated the effects of three disease-management protocols on a combined endpoint of death (from any cause) and heart failure rehospitalization. A total of 1023 patients hospitalized with heart failure in the Netherlands were randomized to either a control group (four follow-up visits with a cardiolog…