Benefits & Challenges of Outpatient UF Therapy
By Laura Serrano / July 7, 2022
Renowned Heart Failure Clinicians Discuss the Benefits and Challenges of Outpatient Ultrafiltration Therapy
On June 21, 2022, Nuwellis hosted a webinar discussion about using outpatient ultrafiltration therapy to break the cycle of heart failure readmissions. We were joined by three world-renowned heart failure (HF) clinicians who work with patients experiencing fluid overload challenges every day. Dr. Detlef Wencker, Dr. Ramesh Emani, and Mr. Patrick Correlli, PA, shared their experiences using Aquadex therapy and discussed the current clinical landscape, including the patient experience and the reimbursement picture.
Below we’ll discuss some of the key discussion points and takeaways from the webinar.
The problem: HF Patients with Fluid Overload Face a Costly Cycle of Hospital Readmissions
The current standard of care for managing fluid overload among HF patients is clinically and economically challenging for patients and hospitals. The vast majority of HF patients with signs of fluid overload are hospitalized and endure long, costly inpatient stays. When they are discharged, patients typically will have unresolved congestion issues that can lead to readmission.
- Roughly 25% of patients are readmitted within 30 days
- Roughly 50% of patients are readmitted within 90 days
Dr. Emani spoke to the need to fully treat a patient’s congestion issues, and how that is more effective in an outpatient setting. Current outpatient strategies center on IV diuretics, but better solutions are needed to break the readmission cycle and bring down costs. Outpatient ultrafiltration with Aquadex therapy offers a viable alternative.
Dr. Wencker noted that ultrafiltration removes a significantly higher amount of sodium compared with hypotonic urine produced by diuretics. Mr. Correlli added that outpatient ultrafiltration helps to stabilize patients without the costs of inpatient care. He believes this is a paradigm shift in how doctors can manage these patients and prevent continuous inpatient stays.
Benefits of Aquadex for HF Patients
The doctors spoke about some of the major benefits HF patients see with Aquadex outpatient ultrafiltration:
- Taking a diuretic holiday has been shown to restore diuretic responsiveness
- 53% reduction in risk of rehospitalizations for HF compared to diuretics
- Early initiation of ultrafiltration in HF patients is shown to reestablish euvolemia and may decrease hospital length of stays
Ultrafiltration Patient Selection and Experience
Who benefits most from outpatient ultrafiltration?
Dr. Wencker believes Aquadex is ideal for patients who are resistant to diuretic therapy. He also stressed that using ultrafiltration with diuretics can help the diuretic process work better for patients than just using diuretics alone.
Dr. Emani spoke about how patients liked having Aquadex as an option and certainly prefer to be able to sleep in their own bed and spend time with their families, rather than in the hospital. Most of these patients have faced hospitalizations in the past and are eager to avoid readmissions. Adding amenities like a nice recliner chair helps the experience, and it’s also important to temper expectations for a process that can take a few days to produce a lasting effect.
* Payment rates collected from the 2022 Medicare Physician Fee Schedule and represents national averages.
Reimbursement subject to established billing rules and payer coverage policies.
1. Gheorghiade M, et al. Eur Heart J Suppl. 2005;7:B13-9.
2. Premier Applied Sciences Database
3. Costanzo MR, et al. J Am Coll Cardiol. 2017 May 16;69(19):2428-2445.