Post-discharge heart failure monitoring program in Turkey: Hit-PoinT

被引:10
作者
Cavusoglu, Yuksel [1 ]
Zoghi, Mehdi [2 ]
Eren, Mehmet [3 ]
Bozcali, Evin [4 ]
Kozdag, Guliz [5 ]
Senturk, Tunay [6 ]
Alicik, Guray [7 ]
Soylu, Korhan [8 ]
Sari, Ibrahim [9 ]
Berilgen, Rida [10 ]
Temizhan, Ahmet [11 ]
Gencer, Erkan [1 ]
Orhan, Ahmet Lutfu [3 ]
Polat, Veli [4 ]
Kaderli, Aysel Aydin [6 ]
Aktoz, Meryem [7 ]
Zengin, Halit [8 ]
Aksoy, Mehmet [9 ]
Selcuk, Mehmet Timur [11 ]
Ergene, Oktay [10 ]
Soran, Ozlem [12 ]
机构
[1] Eskisehir Osmangazi Univ, Fac Med, Dept Cardiol, Eskisehir, Turkey
[2] Ege Univ, Fac Med, Dept Cardiol, Izmir, Turkey
[3] Dr Siyami Ersek Thorac & Cardiovasc Surg Educ & T, Dept Cardiol, Istanbul, Turkey
[4] Sanliurfa Balikligol Hosp, Dept Cardiol, Urfa, Turkey
[5] Kocaeli Univ, Fac Med, Dept Cardiol, Kocaeli, Turkey
[6] Uludag Univ, Fac Med, Dept Cardiol, Bursa, Turkey
[7] Trakya Univ, Fac Med, Dept Cardiol, Edirne, Turkey
[8] Ondokuz Mayis Univ, Fac Med, Dept Cardiol, Samsun, Turkey
[9] Gaziantep Univ, Fac Med, Dept Cardiol, Gaziantep, Turkey
[10] Izmir Ataturk Hosp, Dept Cardiol, Izmir, Turkey
[11] Ankara Yuksek Ihtisas Hosp, Dept Cardiol, Ankara, Turkey
[12] Univ Pittsburgh, Dept Cardiol, Fac Med, Pittsburgh, PA USA
关键词
heart failure; disease management; cardiovascular; health education; outcomes; DISEASE MANAGEMENT PROGRAMS; OLDER PATIENTS; FOLLOW-UP; HIGH-RISK; CARE; SYSTEM; ADMISSION; TRIAL; INTERVENTION; METAANALYSIS;
D O I
10.14744/AnatolJCardiol.2016.6812
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: The aim of this study was to assess the efficacy and feasibility of an enhanced heart failure (HF) education with a 6-month telephone follow- up program in post-discharge ambulatory HF patients. Methods: The Hit-Point trial was a multicenter, randomized, controlled trial of enhanced HF education with a 6-month telephone follow-up program (EHFP) vs routine care (RC) in patients with HF and reduced ejection fraction. A total of 248 patients from 10 centers in various geographical areas were randomized: 125 to EHFP and 123 to RC. Education included information on adherence to treatment, symptom recognition, diet and fluid intake, weight monitoring, activity and exercise training. Patients were contacted by telephone after 1, 3, and 6 months. The primary study endpoint was cardiovascular death. Results: Although all-cause mortality didn't differ between the EHFP and RC groups (p=NS), the percentage of cardiovascular deaths in the EHFP group was significantly lower than in the RC group at the 6-month follow up (5.6% vs. 8.9%, p=0.04). The median number of emergency room visits was one and the median number of all cause hospitalizations and heart failure hospitalizations were zero. Twenty-tree percent of the EHFP group and 35% of the RC group had more than a median number of emergency room visits (p=0.05). There was no significant difference regarding the median number of all-cause or heart failure hospitalizations. At baseline, 60% of patients in EHFP and 61% in RC were in NYHA Class III or IV, while at the 6-month follow up only 12% in EHFP and 32% in RC were in NYHA Class III or IV (p=0.001). Conclusion: These results demonstrate the potential clinical benefits of an enhanced HF education and follow up program led by a cardiologist in reducing cardiovascular deaths and number of emergency room visits with an improvement in functional capacity at 6 months in post-discharge ambulatory HF patients
引用
收藏
页码:107 / 112
页数:6
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