HF Group Appointments Rehospitalization Prevention

HF 团体预约再住院预防

• 批准号: 7129228
• 负责人: CAROL E SMITH
• 金额: $ 72.06万
• 依托单位: UNIVERSITY OF KANSAS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-01 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7129228
• 关键词: behavioral /social science research tag; cardiovascular disorder education; clinical research; clinical trials; cost effectiveness; dyspneas; edema; educational resource design /development; functional ability; group counseling; health services research tag; heart failure; hospital utilization; human mortality; human subject; human therapy evaluation; mathematical model; quality of life; self care; tachycardia; telemedicine; therapy compliance; videotape /videodisc; weight gain

DESCRIPTION (provided by applicant): This study addresses, "Self-Management Strategies Across Chronic Diseases" and Healthy People 2010 goal 12-6 to reduce HF hospitalizations. Heart failure (HF) affects 5 million Americans, with costs estimated at $28.8 billion annually. Yet, in 2004, only 31% of HF patients received even the basic JCAHO- recommended discharge education. Public Health can be approved by intensive HF discharge and post- hospital follow-up programs. Thus, a practical intervention was created that combines HF patient group clinic appointments/multidisciplinary discussion sessions and structured self-management with patient checklist diaries, algorithms and telephone reinforcement. The intervention is based on American College of Cardiology national guidelines, emphasizing patient self-management and the Healthcare Improvement Initiative for Idealized Clinical Practices. To assure all patients in the study have the equal and nationally recommended HF education each subject is provided with our HF videotape series (produced under SBIR 1R43AG). The specific aims are to test effects of the intervention on the composite primary endpoint of rehospitalization or death and secondary endpoints of health services use, cost efficiency, patient health status and HF quality of life. Also measured are patient HF knowledge, self- management behavior, preparedness for home care, participation with professionals and timeliness of symptom-reporting. This is a randomized clinical trial with 1 treatment and 1 standard care (control) group. Each group will have 92 HF patients, total sample of n=184. Multivariate linear mixed model analyses will be used to test effects of the intervention over 12 months. Traditional cost analysis and innovative cost- efficiency Data Envelopment Analysis will be used to compare group intervention costs. Comparisons of costs to other HF programs will be reported. The long-term goals are to improve HF self-management and timely reporting of symptoms using safe and cost-efficient and practical interventions. The group clinic appointments with discussion sessions support and engage patients in self-management (checklist diaries/symptom reporting algorithms), strengthen their HF home management and reduce overall re- hospitalization rates.

描述（由申请人提供）：本研究涉及“慢性病的自我管理策略”和“健康人 2010”目标 12-6，以减少心力衰竭住院治疗。心力衰竭 (HF) 影响 500 万美国人，每年造成的费用估计为 288 亿美元。然而，2004 年，只有 31% 的心力衰竭患者接受了 JCAHO 推荐的基本出院教育。公共卫生可以通过强化高频出院和出院后随访计划来获得批准。因此，创建了一种实用的干预措施，将心力衰竭患者小组诊所预约/多学科讨论会议和结构化自我管理与患者清单日记、算法和电话强化相结合。该干预措施基于美国心脏病学会国家指南，强调患者自我管理和理想化临床实践的医疗保健改进计划。为了确保研究中的所有患者都接受国家推荐的平等高频教育，为每个受试者提供了我们的高频录像带系列（根据 SBIR 1R43AG 制作）。具体目的是测试干预措施对再住院或死亡的复合主要终点以及卫生服务使用、成本效率、患者健康状况和心力衰竭生活质量的次要终点的影响。还测量患者心力衰竭知识、自我管理行为、家庭护理准备情况、专业人员的参与以及症状报告的及时性。这是一项随机临床试验，有 1 个治疗组和 1 个标准护理（对照组）组。每组有 92 名心力衰竭患者，总样本 n=184。将使用多元线性混合模型分析来测试 12 个月内干预措施的效果。传统成本分析和创新成本效率数据包络分析将用于比较群体干预成本。将报告与其他 HF 计划的成本比较。长期目标是使用安全、具有成本效益且实用的干预措施来改善心力衰竭的自我管理并及时报告症状。团体门诊预约和讨论会支持患者进行自我管理（清单日记/症状报告算法），加强他们的心力衰竭家庭管理并降低总体再住院率。