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- William K Silverstein, Sarah Lawrason, Iris Carabuena, Rodrigo B Cavalcanti, Stella Kozuszko, Thomas E MacMillan, Shail Rawal, Lara Wyss, Anne Simard, Heather J Ross, and Tarek Abdelhalim.
- Department of Medicine, University of Toronto, Toronto, ON, Canada; Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, ON Canada; Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON Canada; HoPingKong Centre for Excellence in Education and Practice, University Health Network, Toronto, ON, Canada. Electronic address: William.Silverstein@mail.utoronto.ca.
- Am. J. Med. 2024 Dec 26.
BackgroundFew GIM-specific heart failure transition of care (TOC) programs exist. We thus piloted a TOC program for heart failure patients discharged from GIM that incorporates a remote patient management program, Medly.MethodsThis single-centre, prospective proof-of-concept study described sociodemographic and medical characteristics of included patients, and computed summary statistics to describe clinical and workload outcomes.ResultsTen patients (median age: 85) enrolled. There was no heart failure-related deaths, re-hospitalizations, or ED visits within 90 days of hospital discharge. One urgent GIM clinic visit was needed.ConclusionThis post-GIM TOC pathway appears to effectively support heart failure patients. Further studies should assess this innovation's scalability.Copyright © 2024. Published by Elsevier Inc.
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