Home-Delivered Meals Postdischarge From Heart Failure Hospitalization (GOURMET-HF)
An Evidence-Based Practice
Description
This is a 12 week, three center, randomized controlled trial created to determine the efficacy of home-delivered sodium-restricted Dietary Approaches to Stop Hypertension (DASH/SRD)-compliant meals in older adults, aged 65 years and older, following discharge from a hospital admission for acutely decompensated heart failure. Study subjects received either pre-prepared, home-delivered DASH/SRD-compliant meals or attention control for 4 weeks after hospital discharge. The three study sites will be Columbia University Medical Center, the Ann Arbor Veterans Affairs Health System, and the University of Michigan Health System. Investigators were blinded to group assignment, food diaries, and urinary electrolyte measurements until the completion of the study
Goal / Mission
The goals of GOURMET-HF are to assess the safety of the intervention, including effects on cardiac biomarkers and rehospitalization burden.
Impact
Home-delivered DASH/SRD after HF hospitalization appear safe in selected patients and had favorable effects on HF clinical status and 30-day readmissions. The GOURMET-HF pilot study suggests that postdischarge nutritional support has the potential to improve HF symptoms and reduce readmissions
Results / Accomplishments
The primary outcome was the between-group change in the Kansas City Cardiomyopathy Questionnaire summary score from discharge to 4 weeks postdischarge. Additional outcomes included changes in the Kansas City Cardiomyopathy Questionnaire clinical summary score and cardiac biomarkers. All patients were followed 12 weeks for death/all-cause readmission and potential diet-related adverse events (symptomatic hypotension, hyperkalemia, acute kidney injury). Sixty-six patients were randomized 1:1 at discharge to DASH/SRD versus usual care (age, 71±8 years; 30% female; ejection fraction, 39±18%). The Kansas City Cardiomyopathy Questionnaire summary score increased similarly between groups (DASH/SRD 46±23– 59±20 versus usual care 43±19–53±24; p=0.38), but the Kansas City Cardiomyopathy Questionnaire clinical summary score increase tended to be greater in DASH/SRD participants (47±22–65±19 versus 45±20–55±26; p=0.053). Potentially diet-related adverse events were uncommon; 30-day HF readmissions (11% versus 27%; p=0.06) and days rehospitalized within that timeframe (17 versus 55; p=0.055) trended lower in DASH/SRD participants.
About this Promising Practice
Organization(s)
University of Michigan
Primary Contact
Scott Hummel, MD, MS
CARDIOVASCULAR CENTER
Floor 3 Reception C
1500 E Medical Center Dr SPC 5856
Ann Arbor, MI 48109-5856
888-287-1082
https://www.uofmhealth.org/profile/969/scott-lowel...
CARDIOVASCULAR CENTER
Floor 3 Reception C
1500 E Medical Center Dr SPC 5856
Ann Arbor, MI 48109-5856
888-287-1082
https://www.uofmhealth.org/profile/969/scott-lowel...
Topics
Health / Heart Disease & Stroke
Health / Physical Activity
Health / Older Adults
Health / Physical Activity
Health / Older Adults
Organization(s)
University of Michigan
Source
Circulation Heart Failure Journal
Date of publication
8/10/2018
Date of implementation
May 2014
Location
Columbia University Medical Center, the Ann Arbor Veterans Affairs Health System, and the University of Michigan Health System
For more details
Target Audience
Adults, Women, Men, Older Adults