Going To The Doctor Pays Off After Heart Failure

By Susan E. Matthews

Returning to the doctor after a hospital stay due to heart failure increases the chance of survival -- particularly if you head back to your regular physician, according to a new study done in Canada.

Researchers at the University of Alberta used databases tracking 24,373 patients who were admitted for first-time heart failure in the Alberta province from January 1999 to June 2009. Of all of the patients, 21.9 percent did not visit a doctor in the first month, while 69.2 percent saw a familiar physician, defined as someone the patient had seen at least twice in the year before their heart failure, and 9 percent saw an unfamiliar physician. Patients who saw a physician, whether familiar or unfamiliar, had a 43.6 percent risk of death or unplanned readmission within six months, compared to a 62.9 percent risk for patients who didn't see a doctor.

Furthermore, the patients who consistently continued to see a familiar physician, were less likely to be readmitted or to die over the six month period than patients who saw unfamiliar physicians.

"Early physician follow-up after discharge and physician continuity were both associated with better outcomes among patients with heart failure," the researchers wrote in their paper, published in the Canadian Medical Association Journal.

The study's data should help encourage patients that going to the doctor really does help, said William T. Abraham, MD, chief of the division of cardiovascular medicine at Ohio State University College of Medicine. Though going to a doctor who is familiar with your health and family history has a modest impact, the real takeaway is that each "patient ought to be seen in the first 30 days by any physician," he said.

When accounting for other variations between the patients, such as age, the researchers found that a doctor's visit in the first month after discharge was associated with 3 to 8 percent reduction in risk of death or readmission over the next 3-12 months. This risk reduction is equal to that achieved by taking beta blockers or angiotensin-converting-enzyme inhibitors, the researchers wrote.

"Physicians should strive to optimize continuity with their heart-failure patients after discharge and that strategies are needed in the health care system to ensure early follow-up after discharge with the patient's regular physician," they wrote.

Often, the reason why the check-up appointment doesn't happen is because physician's schedules are so packed, Dr. Abraham said. At his clinic, they've taken to scheduling each patient with a nurse practitioner within 7 days, and a physician within 30, and he encouraged doctors to do the same.

The researchers noted that heart failure is one of the most common causes for hospitalization, and often carries a high risk of readmission. The United States and Canada spend more than $20 billion annually on patients who are readmitted to the hospital unexpectedly within 30 days of an initial release, the researchers wrote in their paper.

"It's important to educate patients that when you're discharged following heart failure, the likelihood of you relapsing is very high," Abraham said. Better they do it in a clinic than a hospital, he noted.

"Going to the Doctor Pays Off After Heart Failure ^[4] " originally appeared on Everyday Health.