CLINICAL
NEWS JOURNAL WRAP
Does
Telemonitoring
Reduce HF
Readmissions?
with HF “because of the impending
potential penalties from the Hospital
Readmission Program and had implemented readmission reduction efforts.”
The authors ultimately concluded
that the combination of remote patient
monitoring with care transition management did not reduce 180-day all-cause
readmission after hospitalization for HF,
but moving forward, further studies are
needed to confirm their findings.
In a related editorial comment,
Kumar Dharmarajan, MD, MBA,
and Sarwat I. Chaudhry, MD, note
that “further reductions in readmissions in HF will require novel
approaches that enhance the effectiveness of telemonitoring or target newly
recognized pathways to readmission,
such as common hospital stressors or
the persistence of symptoms experienced by patients after hospital
discharge.” They add that “whatever
format such strategies take place,
In patients hospitalized for heart failure
(HF), health coaching telephone calls
and telemonitoring did not reduce
180-day readmissions, according to a
study published Feb. 8 in JAMA Internal
Medicine.
The study looked at 1,437
patients hospitalized with HF who
were randomized to an intervention
arm—which consisted of combined
health coaching telephone calls and
telemonitoring—or usual care, and
were observed for 180 days.
Results showed that the intervention
and usual care groups “did not differ
significantly” in readmissions for any
cause 180 days after discharge (50.8%
and 49.2%, respectively). Further, there
were “no significant differences in 30day readmissions or 180-day mortality,
but there was a significant difference
in 180-day quality of life between the
intervention and usual care groups.”
The authors noted that one possible
explanation for their results may be
that all participating sites were already
focused on readmissions among patients
[T]he intervention
and usual
care groups
“did not differ
significantly” in
readmissions for
any cause 180 days
after discharge.
28 CardioSource WorldNews
Actor Portrayal
Indication
Ranexa is indicated for the
treatment of chronic angina.
Ranexa may be used with
beta-blockers, nitrates, calcium
channel blockers, anti-platelet
therapy, lipid-lowering therapy,
ACE inhibitors, and angiotensin
receptor blockers.
Important Safety Information
Contraindications
Ranexa is contraindicated in patients:
Taking strong inhibitors of CYP3A
(e.g., ketoconazole, itraconazole,
clarithromycin, nefazodone,
nelfinavir, ritonavir, indinavir,
and saquinavir).
Taking inducers of CYP3A (e.g.,
rifampin, rifabutin, rifapentine,
phenobarbital, phenytoin,
carbamazepine, and
St John’s wort)
With liver cirrhosis
Warnings and Precautions
Ranexa blocks lKr and prolongs the
QTc interval in a dose-related
manner.
Clinical experience in an acute
coronary syndrome population
did not show an increased risk of
proarrhythmia or sudden death.
However, there is little experience
with high doses (> 1000 mg twice
daily) or exposure, with other QTprolonging drugs, with potassium
channel variants resulting in a
long QT interval, in patients with
a family history of (or congenital)
long QT syndrome, or in patients
with known acquired QT interval
prolongation.
Acute renal failure has been
observed in patients with severe
renal impairment while on
Ranexa. Monitor renal function
after initiation and periodically in
patients with moderate to severe
renal impairment. Discontinue
Ranexa if acute renal failure
develops.
Adverse Reactions
The most common adverse
reactions (> 4% and more
common than with placebo) during
treatment with Ranexa were
dizziness, headache, constipation,
and nausea.