Résumé
Background: heart failure is a major public health problem. It generates high costs which are mainly related to hospitalizations. Solutions have been suggested to reduce the occurrence of new hospitalizations such as, in particular, multidisciplinary approaches and therapeutic education which seem to be effective. The main objective of our study is to evaluate the effectiveness of the PRADO-ICprotocol, a transitional care program set up in France, in order to reduce rehopitalization for heart failure at one year. Methods: our trial was performed between May 2018 and May 2021. The PRADOC study was a prospective, multicentric, randomized controlled trial of the PRADO-IC, versus usual management transition program in hospitalized patients with heart failure. This was an open-label study, with a blinded evaluation. Patients in the intervention group essentially received an administrative assistance toschedule follow-up visits and a nurse follow-up during two to six months. The primary clinical outcome was the readmission for heart failure at one year.Results: 404 patients were included from May 2018 to May 2021. 203 in the PRADO-IC group and 201 in the control group. The average age was 77 years old and 69.55% of the patients were men. The intervention and conventional care groups were, on the whole, similar in baseline demographics and comorbidities. The primary outcome was readmissions for heart failure at one year. We found no statistically significant differences between the two groups. (HR 1.039 [95%, CI, 0.693-1.557]; p-value= 0.8532).Conclusion: in our multicentric randomized study, the implementation of PRADO-IC, compared to conventional management, did not lead to a decrease in rehospitalization for heart failure at one year. This questions the medico-economic relevance of this program.