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Peer-reviewedCC BY 4.0JACC Case Reports

Reducing Heart Failure Hospitalizations With Proactive Outpatient Diuretic Management

  • Aqsa Iqbal1,2
  • Sannie Sulley3
  • Lee Anheuser1
  • Faelynn Hammond1
  • Chrystal Grant1
  • Corrie Farris1,4
  • Amy Glasco1,4
  • Arslan Mirza1,2,4
4 affiliations
  1. 1Southern Illinois HealthCare, Carbondale, Illinois, USA
  2. 2Southern Illinois University School of Medicine, Springfield, Illinois, USA
  3. 3National Healthy Start Association, Washington, DC, USA
  4. 4Prairie Heart Institute, Carbondale, Illinois, USA
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Abstract

Background: Recurrent congestion remains a major driver of heart failure (HF)–related acute care utilization despite guideline-directed medical therapy.

Project Rationale: The Congestive Heart Failure Navigator program was developed to support early recognition of worsening HF and proactive HF optimization. This study evaluated whether higher outpatient diuretic optimization intensity was associated with reduced HF hospitalizations.

Project Summary: This retrospective quality improvement study evaluated patients enrolled in the Congestive Heart Failure Navigator program during 2025. Temporal associations between prior-month oral diuretic optimization and HF hospitalizations were analyzed using regression models. The program managed a mean of 54 patients monthly, with hospitalization rates remaining low (0-9.4 per 100 patients). Higher outpatient diuretic optimization intensity was associated with fewer subsequent HF hospitalizations (incidence rate ratio: ≈0.94; P ≈ 0.046). In a pre-post analysis (n = 38), HF hospitalizations declined from 34.2% to 18.4%.

Take-Home Message: Higher-intensity outpatient oral diuretic optimization may represent a scalable early congestion management strategy associated with reduced HF hospitalizations.

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Cite

BibTeXRIS
BibTeX
@article{iqbal2026reducing,
  title = {{Reducing Heart Failure Hospitalizations With Proactive Outpatient Diuretic Management}},
  author = {Aqsa Iqbal and Sannie Sulley and Lee Anheuser and Faelynn Hammond and Chrystal Grant and Corrie Farris and Amy Glasco and Arslan Mirza},
  journal = {JACC Case Reports},
  year = {2026},
  month = sep,
  doi = {10.1016/j.jaccas.2026.109117},
  url = {https://doi.org/10.1016/j.jaccas.2026.109117},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Reducing Heart Failure Hospitalizations With Proactive Outpatient Diuretic Management
AU  - Aqsa Iqbal
AU  - Sannie Sulley
AU  - Lee Anheuser
AU  - Faelynn Hammond
AU  - Chrystal Grant
AU  - Corrie Farris
AU  - Amy Glasco
AU  - Arslan Mirza
PY  - 2026
DA  - 2026/09/16
JO  - JACC Case Reports
DO  - 10.1016/j.jaccas.2026.109117
UR  - https://doi.org/10.1016/j.jaccas.2026.109117
AB  - Background: Recurrent congestion remains a major driver of heart failure (HF)–related acute care utilization despite guideline-directed medical therapy.  Project Rationale: The Congestive Heart Failure Navigator program was developed to support early recognition of worsening HF and proactive HF optimization. This study evaluated whether higher outpatient diuretic optimization intensity was associated with reduced HF hospitalizations.  Project Summary: This retrospective quality improvement study evaluated patients enrolled in the Congestive Heart Failure Navigator program during 2025. Temporal associations between prior-month oral diuretic optimization and HF hospitalizations were analyzed using regression models. The program managed a mean of 54 patients monthly, with hospitalization rates remaining low (0-9.4 per 100 patients). Higher outpatient diuretic optimization intensity was associated with fewer subsequent HF hospitalizations (incidence rate ratio: ≈0.94; P ≈ 0.046). In a pre-post analysis (n = 38), HF hospitalizations declined from 34.2% to 18.4%.  Take-Home Message: Higher-intensity outpatient oral diuretic optimization may represent a scalable early congestion management strategy associated with reduced HF hospitalizations.
SN  - 2666-0849
ER  -