Original article Early Postdischarge STOP-HF-Clinic Reduces 30-day Readmissions in Old and Frail Patients With Heart Failure Cristina Pacho, a,b Mar Domingo, c Raquel Nu ´n ˜ez, a Josep Lupo ´ n, b,c,d Pedro Moliner, c Marta de Antonio, b,c Beatriz Gonza ´ lez, c Javier Santesmases, a,c Emili Vela, e Jordi Tor, a,b and Antoni Bayes-Genis b,c,d, * a Servei de Medicina Interna y Unitat de Geriatria d’Aguts, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain b Departament de Medicina, Universitat Auto `noma de Barcelona, Barcelona, Spain c Servei de Cardiologia-Unitat d’IC, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain d CIBER-CV (CB16/11/00403), Instituto de Salud Carlos III, Madrid, Spain e Divisio ´ d’Ana `lisi de la Demanda i l’Activitat, Servei Catala ` de la Salut, Barcelona, Spain Rev Esp Cardiol. 2017;70(8):631–638 Article history: Received 31 October 2016 Accepted 21 December 2016 Available online 16 February 2017 Keywords: Heart failure Rehospitalizations Elderly Transitional care Multidisciplinarity A B S T R A C T Introduction and objectives: Heart failure (HF) is associated with a high rate of readmissions within 30 days postdischarge. Strategies to lower readmission rates generally show modest results. To reduce readmission rates, we developed a STructured multidisciplinary outpatient clinic for Old and frail Postdischarge patients hospitalized for HF (STOP-HF-Clinic). Methods: This prospective all-comers study enrolled patients discharged from internal medicine or geriatric wards after HF hospitalization. The intervention involved a face-to-face early visit (within 7 days), HF nurse education, treatment titration, and intravenous medication when needed. Thirty-day readmission risk was calculated using the CORE-HF risk score. We also studied the impact of 30-day readmission burden on regional health care by comparing the readmission rate in the STOP-HF-Clinic Referral Area (250 000 people) with that of the rest of the Catalan Health Service (CatSalut) (7.5 million people) during the pre–STOP-HF-Clinic (2012-2013) and post–STOP-HF-Clinic (2014-2015) time periods. Results: From February 2014 to June 2016, 518 consecutive patients were included (age, 82 years; Barthel score, 70; Charlson index, 5.6, CORE-HF 30-day readmission risk, 26.5%). The observed all-cause 30-day readmission rate was 13.9% (47.5% relative risk reduction) and the observed HF-related 30-day readmission rate was 7.5%. The CatSalut registry included 65 131 index HF admissions, with 9267 all- cause and 6686 HF-related 30-day readmissions. The 30-day readmission rate was significantly reduced in the STOP-HF-Clinic Referral Area in 2014-2015 compared with 2012-2013 (P < .001), mainly driven by fewer HF-related readmissions. Conclusions: The STOP-HF-Clinic, an approach that could be promptly implemented elsewhere, is a valuable intervention for reducing the global burden of early readmissions among elder and vulnerable patients with HF.  C 2017 Sociedad Espan ˜ola de Cardiologı ´a. Published by Elsevier Espan ˜a, S.L.U. All rights reserved. Una consulta especı ´fica al alta (STOP-HF-Clinic) reduce los reingresos a 30 dı´as de los pacientes ancianos y fra ´ giles con insuficiencia cardiaca Palabras clave: Insuficiencia cardiaca Rehospitalizaciones Ancianos Cuidados transicionales Multidisciplinariedad R E S U M E N Introduccio ´n y objetivos: La insuficiencia cardiaca (IC) se asocia a una alta tasa de reingreso en los 30 dı ´as posteriores al alta. Las estrategias para reducir los reingresos han mostrado, en general, resultados moderados. Hemos desarrollado una consulta multidisciplinaria estructurada ambulatoria para pacientes ancianos y fra ´ giles tras el alta de un ingreso por IC (STOP-HF-Clinic), con el objetivo de reducir estas tasas de reingreso. Me ´todos: Estudio prospectivo que incluye a todos los pacientes dados de alta de medicina interna o geriatrı ´a tras una hospitalizacio ´n por IC. Intervencio ´ n: visita presencial temprana (antes de 7 dı ´as), educacio ´n sobre IC por enfermerı ´a, titulacio ´n del tratamiento y administracio ´n de medicamentos intravenosos cuando fuera necesario. El riesgo de reingreso a 30 dı ´as se calculo ´ utilizando la puntuacio ´n de riesgo CORE-HF. Tambie ´n se estudio ´ el impacto de la carga de reingresos a 30 dı ´as en la atencio ´n sanitaria regional comparando la tasa de reingresos en el a ´ rea de referencia de la STOP-HF-Clinic SEE RELATED CONTENT: http://dx.doi.org/10.1016/j.rec.2017.03.007, Rev Esp Cardiol. 2017;70:624–625. * Corresponding author: Servicio de Cardiologı ´a, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, 08916 Badalona, Barcelona, Spain. E-mail address: abayesgenis@gmail.com (A. Bayes-Genis). http://dx.doi.org/10.1016/j.rec.2017.01.003 1885-5857/  C 2017 Sociedad Espan ˜ola de Cardiologı ´a. Published by Elsevier Espan ˜a, S.L.U. All rights reserved. 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