Effectiveness of a follow-up program for elderly heart failure patients after hospital discharge. A randomized controlled trial |
| |
| Affiliation: | 1. Geriatric Service, Hospital Ntra. Sra. de la Montaña, Complejo Hospitalario de Cáceres, Avenue España 2, 10004 Cáceres, Spain;2. Department of Patient Management, Complejo Hospitalario de Cáceres, Cáceres, Spain;3. Faculty of Sports Sciences, University of Extremadura, Cáceres, Spain;4. Geriatric Service, Hospital Clínico San Carlos de Madrid, Madrid, Spain;1. Unit and School of Geriatrics, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria n. 1, 98125 Messina, Italy;2. Unit and School of Nephrology, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria n. 1, 98125 Messina, Italy;3. Department of Experimental Pathology and Microbiology, University of Messina, Via Consolare Valeria n. 1, 98125 Messina, Italy;1. College of Nursing & Research Institute of Nursing Science, Seoul National University, Seoul, South Korea;2. College of Nursing, Seoul National University, Seoul, South Korea;3. Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea;1. Ankara University Faculty of Medicine, Nephrology Department, Ankara, Turkey;2. Ankara University Faculty of Medicine, Geriatric Medicine Department, Ankara, Turkey;3. Ankara University Faculty of Medicine, Immunology and Allergy Department, Ankara, Turkey;1. School of Mathematics and Statistics, Zhengzhou University, Zhengzhou 450052, China;2. School of Mathematics and Information Science, North China University of Water Resources and Electric Power, Zhengzhou 450011, China;1. Department of Geriatrics, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium;2. Department of Haematology, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium |
| |
| Abstract: | PurposeManagement programs for high-risk heart failure (HF) patients reduce admission rates, improve quality of life and survival, and lower costs. These benefits are controversial in elderly patients because these individuals are frequently excluded from the studies. Our aim was to evaluate the effectiveness of disease management programs (DMPs) for HF elderly patients attending a geriatric day care hospital (GDCH) subsequent to hospital discharge.MethodsA randomized prospective study was performed using 117 HF patients who were divided into two groups as follows: 59 patients undergoing an interventional program including health education, therapeutic control, and close follow-up in a GDCH; and 58 patients receiving standard healthcare. Results were measured in terms of event-free survival, where “event” is defined as readmission or mortality for any cause.ResultsThe mean age was 85 years, and 73% of the patients were women. After a year of follow-up, the intervention group had fewer patients with events compared with the control group (27 vs. 38 patients), which indicates a 30% reduction (RR: 2.25; 95% CI: 1.07–4.74; P = 0.032). The probability of having an event between the first visit and the year of follow-up was significantly lower in the intervention group (log-rank: 5.79; P = 0.016). Moreover, the quality of life improved significantly in the intervention group (P = 0.035).ConclusionA developed DMP in a GDCH improves the event-free survival and the quality of life in elderly patients with HF.Trial registrationisrctn.org identifier: ISRCTN10823032. |
| |
| Keywords: | Heart failure Elderly patients Disease management programs |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
