Unrecognized Cognitive Impairment in Heart Failure Patients Increases Costs and Readmissions

MedicalResearch.com Interview with:

Mark W Ketterer PhD, ABPP Health Psychology Henry Ford Hospital Detroit Michigan

Dr. Mark Ketterer

Mark W Ketterer PhD, ABPP
Health Psychology
Henry Ford Hospital
Detroit Michigan

MedicalResearch.com: What is the background for this study? What are the main findings? 

Dr. Ketterer:  Reducing wasteful healthcare costs is a high priority For Medicare/Medicaid, Obamacare and all third party payors.  Cognitive impairment (CI) is highly prevalent in patients  with chronic illnesses identified as having high readmission rates by the Center for Medicare and Medicaid Services (1,2,3), such as Congestive Heart Failure (4,5), End Stage Renal Disease (6,7) and Chronic Obstructive Pulmonary Disease (8-14). CI  is also a known prospective predictor of longer term admissions and deaths (15-18). Poor adherence is a frequent consequence of cognitive impairment (19,20), particularly when the family and/or patient have not yet recognized and intervened for the evolving problem, or the patient is not in a setting (e.g., Nursing Homes) that supervises medication administration

MedicalResearch.com: What should clinicians and patients take away from your report? 

Dr. Ketterer:  

  • Aggressive evaluation of heart failure patients for cognitive impairment.
  • Involvement of family in maximizing adherence is better care, and more efficient care.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Ketterer:  A randomly-assigned, controlled clinical trial of this intervention is warranted, needed and should be a high priority in healthcare research.

MedicalResearch.com: Is there anything else you would like to add? 

Dr. Ketterer:  As currently constructed, our healthcare system neglects common behavioral causes of waste, misdiagnosis and treatment failure.  Nonrecognition of cognitive impairment in heart failure patients is about 90%.  This can be a catastrophic failure for a given patient, resulting in a preventable death.

Citation:

Cognitive Impairment and Reduced Early Readmissions in Congestive Heart Failure? –

Mark W. Ketterer, PhD; Jennifer Peltzer, PsyD; Usamah Mossallam, MD; Cathy Draus, RN; John Schairer, DO; Bobak Rabbani, MD; Khaled Nour, MD; Gayathri Iyer, MD; Michael Hudson, MD; and James McCord, MD –

American Journal Managed Care Published Online: January 25, 2016

Mark W Ketterer PhD, ABPP (2016). Unrecognized Cognitive Impairment in Heart Failure Patients Increases Costs and Readmissions 

2 thoughts on “Unrecognized Cognitive Impairment in Heart Failure Patients Increases Costs and Readmissions

    • Done. Age was NOT a predictor of early readmission in our first study (Ketterer et al., Psychosomatics 2014). Age is likely confounded w CI (Ketterer et al., Psychosomatics in press) but this is orthogonal to the question of whether recognizing & intervening reduces recurrent medical crises resulting in admission. We would want good care for our older patients too.

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