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Background <p>While risk-stratified heart failure screening demonstrates clinical value in enabling early intervention, current implementation remains limited globally. This study aims to develop and validate a multi-stakeholder collaborative screening framework based on primary healthcare system.</p> Methods <p>We conducted the Pudong Heart Failure Screening Project (PHSP) in the medical consortium in Shanghai. The PHSP was delivered via five phases: (a) investigation, (b) screening, (c) individual invitation, (d) consultation in primary health care and (e) management in secondary health care. Data were collected by electronic data capture (EDC) system, office administrators and GPs. Univariate and multivariate logistic regression analysis was used to examine the relationship between the outcomes and factors.</p> Results <p>A total of 8022 individuals took part in the PHSP and 2473 participants (30.83%) were initially defined positive in the screening. Among the 2473 positive participants, 1553 responded to the invitation call, and 664 individuals accepted the invitation to visit the Cardiologist-driven GP joint clinic. Notably, house price was identified as a significant factor influencing their decision to accept the invitation (OR = 7.598, 95%CI (1.717–33.621), <i>p</i> &lt; 0.05). Finally, a total of 563 patients visited the clinic and 307 positive individuals visited the secondary care institution. The use of an AI-assisted referral system significantly increased attendance at secondary care (OR = 11.4). The cost of the screening program was 12.25 US per individual screened and 39.73 US per positive individual identified.</p> Conclusions <p>PHSP identified older adults at early risk of heart failure through low-cost community screening. The collaboration of multiple parties ensured the full implementation of the screening project and it was a typical practice case in the realm of implementation science worthy of promotion in more regions.</p> Trial registration <p>The study was retrospectively registered in <a href="https://www.clinicaltrials.gov/">https://www.clinicaltrials.gov/</a>, trial registration number: NCT06673615, and data of registration: September 23, 2024.</p>

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Implementing community-based heart failure screening in primary care settings: a population-based pilot study in Shanghai, China

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月18日

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  • Xin Gong,
  • Jie Xu,
  • Min Wang,
  • Hao Hu,
  • Yuge Yan,
  • Wei Han,
  • Jiaoling Huang

摘要

Background

While risk-stratified heart failure screening demonstrates clinical value in enabling early intervention, current implementation remains limited globally. This study aims to develop and validate a multi-stakeholder collaborative screening framework based on primary healthcare system.

Methods

We conducted the Pudong Heart Failure Screening Project (PHSP) in the medical consortium in Shanghai. The PHSP was delivered via five phases: (a) investigation, (b) screening, (c) individual invitation, (d) consultation in primary health care and (e) management in secondary health care. Data were collected by electronic data capture (EDC) system, office administrators and GPs. Univariate and multivariate logistic regression analysis was used to examine the relationship between the outcomes and factors.

Results

A total of 8022 individuals took part in the PHSP and 2473 participants (30.83%) were initially defined positive in the screening. Among the 2473 positive participants, 1553 responded to the invitation call, and 664 individuals accepted the invitation to visit the Cardiologist-driven GP joint clinic. Notably, house price was identified as a significant factor influencing their decision to accept the invitation (OR = 7.598, 95%CI (1.717–33.621), p < 0.05). Finally, a total of 563 patients visited the clinic and 307 positive individuals visited the secondary care institution. The use of an AI-assisted referral system significantly increased attendance at secondary care (OR = 11.4). The cost of the screening program was 12.25 US per individual screened and 39.73 US per positive individual identified.

Conclusions

PHSP identified older adults at early risk of heart failure through low-cost community screening. The collaboration of multiple parties ensured the full implementation of the screening project and it was a typical practice case in the realm of implementation science worthy of promotion in more regions.

Trial registration

The study was retrospectively registered in https://www.clinicaltrials.gov/, trial registration number: NCT06673615, and data of registration: September 23, 2024.