{"id":"ce3b053ce610","type":"article","url":"https://hartvaat.nl/2017/08/07/standaard-versus-geintensiveerd-hartfalenmanagement-en-zorgkosten-gerandomiseerd/","title":"Standaard versus geïntensiveerd hartfalenmanagement en zorgkosten: gerandomiseerde trial","title_en":"Standard vs. intensified management of heart failure to reduce healthcare costs: results of a multicentre, randomized controlled trial.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":[],"journal":"European heart journal","doi":"10.1093/eurheartj/ehx259","source_url":"https://doi.org/10.1093/eurheartj/ehx259","authors":["P A Scuffham","J Ball","J D Horowitz","C Wong","P J Newton","P Macdonald","J McVeigh","A Rischbieth","N Emanuele","M J Carrington","C M Reid","Y K Chan","S Stewart"],"significance":6,"published":"2017-08-07","source_date":"2017-08-07","image":"","kennis":[],"congress":"","summary_en":"This multicenter randomized trial compared standard versus intensified heart failure management programs on healthcare costs, evaluating whether individualized profiling and more frequent monitoring reduce the economic burden of heart failure.","created":"2026-07-03T10:26:50Z","updated":"2026-07-03T13:26:07Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Multicenter gerandomiseerde trial die standaard versus geïntensiveerd hartfalenmanagement vergeleek op zorgkosten. Economische evaluatie van intensieve HF-programma's.","abstract_original":"AIMS: To determine if an intensified form of heart failure management programme (INT-HF-MP) based on individual profiling is superior to standard management (SM) in reducing health care costs during 12-month follow-up (primary endpoint). METHODS AND RESULTS: A multicentre randomized trial involving 787 patients (full analysis set) discharged from four tertiary hospitals with chronic HF who were randomized to SM (n = 391) or INT-HF-MP (n = 396). Mean age was 74 ± 12 years, 65% had HF with a reduced ejection fraction (31.4 ± 8.9%) and 14% were remote-dwelling. Study groups were well matched. According to Green, Amber, Red Delineation of rIsk And Need in HF (GARDIAN-HF) profiling, regardless of location, patients in the INT-HF-MP received a combination of face-to-face (home visits) and structured telephone support (STS); only 9% (`low risk') were designated to receive the same level of management as the SM group. The median cost in 2017 Australian dollars (A$1 equivalent to ∼EUR €0.7) of applying INT-HF-MP was significantly greater than SM ($152 vs. $121 per patient per month; P < 0.001), However, at 12 months, there was no difference in total health care costs for the INT-HF-MP vs. SM group (median $1579, IQR $644 to $3717 vs. $1450, IQR $564 to $3615 per patient per month, respectively). This reflected minimal differences in all-cause mortality (17.7% vs. 18.4%; P = 0.848) and recurrent hospital stay (18.6 ± 26.5 vs. 16.6 ± 24.8 days; P = 0.199) between the INT-HF-MP and SM groups, respectively. CONCLUSION: During 12-months follow-up, an INT-HF-MP did not reduce healthcare costs or improve health outcomes relative to SM."}