Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/55872
Citations | ||
Scopus | Web of Science® | Altmetric |
---|---|---|
?
|
?
|
Type: | Journal article |
Title: | Effects of a nurse-led, clinic and home-based intervention on recurrent hospital use in chronic heart failure |
Author: | Thompson, D. Roebuck, A. Stewart, S. |
Citation: | European Journal of Heart Failure, 2005; 7(3):377-384 |
Publisher: | Elsevier Science BV |
Issue Date: | 2005 |
ISSN: | 1388-9842 1879-0844 |
Statement of Responsibility: | David R. Thompson, Alun Roebuck and Simon Stewart |
Abstract: | <h4>Background</h4>Few studies have examined the potential benefits of specialist nurse-led programs of care involving home and clinic-based follow-up to optimise the post-discharge management of chronic heart failure (CHF).<h4>Objective</h4>To determine the effectiveness of a hybrid program of clinic plus home-based intervention (C+HBI) in reducing recurrent hospitalisation in CHF patients.<h4>Methods</h4>CHF patients with evidence of left ventricular systolic dysfunction admitted to two hospitals in Northern England were assigned to a C+HBI lasting 6 months post-discharge (n=58) or to usual, post-discharge care (UC: n=48) via a cluster randomization protocol. The co-primary endpoints were death or unplanned readmission (event-free survival) and rate of recurrent, all-cause readmission within 6 months of hospital discharge.<h4>Results</h4>During study follow-up, more UC patients had an unplanned readmission for any cause (44% vs. 22%: P=0.019, OR 1.95 95% CI 1.10-3.48) whilst 7 (15%) versus 5 (9%) UC and C+HBI patients, respectively, died (P=NS). Overall, 15 (26%) C+HBI versus 21 (44%) UC patients experienced a primary endpoint. C+HBI was associated with a non-significant, 45% reduction in the risk of death or readmission when adjusting for potential confounders (RR 0.55, 95% CI 0.28-1.08: P=0.08). Overall, C+HBI patients accumulated significantly fewer unplanned readmissions (15 vs. 45: P<0.01) and days of recurrent hospital stay (108 vs. 459 days: P<0.01). C+HBI was also associated with greater uptake of beta-blocker therapy (56% vs. 18%: P<0.001) and adherence to Na restrictions (P<0.05) during 6-month follow-up.<h4>Conclusion</h4>This is the first randomised study to specifically examine the impact of a hybrid, C+HBI program of care on hospital utilisation in patients with CHF. Its beneficial effects on recurrent readmission and event-free survival are consistent with those applying either a home or clinic-based approach. |
Keywords: | Chronic heart failure Randomised trial Home-based intervention Outpatient clinic Morbidity |
Description: | © 2005 European Society of Cardiology |
DOI: | 10.1016/j.ejheart.2004.10.008 |
Published version: | http://dx.doi.org/10.1016/j.ejheart.2004.10.008 |
Appears in Collections: | Aurora harvest 5 Nursing publications |
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.