Heart failure: preventing rehospitalizations by disease management programs

Chronic heart failure is a growing public health problem for prevalence, morbidity and costs. The major proportion of costs is attributable to rehospitalizations and many of these readmissions may be preventable. Since 1990, some investigators have tested a variety of disease management programs designed to improve quality of life, functional status and decrease rehospitalizations rates. We identified these studies by a computerized search of the MEDLINE database. The programs described reflected a wide variety of methods and we categorized these programs recognizing the prevalent disease management approach. We reported the results of these trials about rehospitalizations and analysed a number of limitations that must be considered when determining their adoption into clinical practice.