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Comment & Response |

Strategies to Reduce Heart Failure Readmissions—Reply

Javed Butler, MD, MPH1; Gregg C. Fonarow, MD2; Mihai Gheorghiade, MD3
[+] Author Affiliations
1Emory University, Atlanta, Georgia
2University of California, Los Angeles
3Center for Cardiovascular Innovation, Northwestern University, Chicago, Illinois
JAMA. 2014;311(11):1160-1161. doi:10.1001/jama.2014.683.
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In Reply We appreciate the efforts of Dr Bradley and colleagues to discover means to reduce readmissions after hospitalizations for heart failure. Our Viewpoint attempted to highlight the multiple issues that are related to the lack of progress in this area.

In reference to the study by Bradley et al,1 we had 4 concerns. First, unlike myocardial infarction, for which quality improvement efforts implemented a robust set of acute interventions proven by randomized clinical trials, there are no such known interventions for heart failure hospitalizations and those that are being implemented are generic. Second, data regarding the effectiveness of these generic interventions have been inconsistent across studies. The Institute for Healthcare Improvement’s 5 Million Lives from Harm campaign committed to a 25% reduction in readmission for heart failure from 2006 to 2008 and used many of these interventions; yet despite thousands of hospitals participating, no reductions in readmission for heart failure were observed.2


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March 19, 2014
Elizabeth H. Bradley, PhD; Leslie A. Curry, MPH, PhD; Harlan M. Krumholz, MD, SM
1Department of Health Management and Policy, Yale School of Public Health, New Haven, Connecticut
JAMA. 2014;311(11):1160. doi:10.1001/jama.2014.678.
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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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