July 27, 2016

Developing new guidelines to help underserved cardiac patients in Detroit

Over the coming months, look for videos, stories and events that feature some of the many Wayne State initiatives and passionate individuals committed to eradicating health disparities. This content is part of WSU's Warriors in Action campaign highlighting how Wayne State is making a difference.

More than 1 million people annually are hospitalized for acute heart failure in the United States and more than 80 percent of those patients are initially treated in emergency rooms. More than 200,000 patients, however, are diagnosed as not serious enough for immediate hospitalization and are discharged from emergency rooms. Many of those patients are from underserved urban communities like Detroit.

Phillip Levy, M.D., M.P.H., professor of emergency medicine and associate chair for research in the Wayne State School of Medicine Department of Emergency Medicine, is managing a three-year study with Detroit Receiving Hospital of the Detroit Medical Center that will serve as a site for a national study to develop new guidelines for patients released from the emergency room after treatment for suspected acute heart failure symptoms.

Levy and the other investigators said their preliminary work demonstrates that the patients going home from the emergency room are many times unsure of their next steps, the medications they should take and when they should schedule follow-up appointments. Patients who are hospitalized, in contrast, undergo pre-discharge consultations explaining this information, and in addition, often receive it in writing. Implementing similar procedures with emergency room patients has never been examined.

The overall three-year project, funded with a $2,083,575 grant from the Patient-Centered Outcomes Research Institute, will be overseen by Sean Collins, M.D., of Vanderbilt University.

Dr. Levy, who also serves as the director of the WSU Clinical Research Center — where study patients will follow up — will enroll participants through the emergency room at Detroit Receiving Hospital. He hopes to enroll 200 of the anticipated 700 study participants.

The study, “Get with the Guidelines in ED Patients with Heart Failure,” will seek to address disparities in the discharge follow-up information provided to two groups — patients with suspected heart failure released after hospitalization, and those seen and released from emergency rooms.

The investigators will implement the American Heart Association’s Get With The Guidelines–Heart Failure program at the study sites. The program is a national initiative of the AHA designed to improve care through consistent adherence to treatment protocols. According to the association, numerous studies have demonstrated the program's success, including reductions in 30-day readmissions for acute heart failure.

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