Heart Failure Group Appointments: Rehospitalization Prevention Clinical Trial

心力衰竭小组预约：再住院预防临床试验

基本信息

批准号：
7622209
负责人：
CAROL E SMITH
金额：
$ 5.64万
依托单位：
UNIVERSITY OF KANSAS MEDICAL CENTER
依托单位国家：
美国
项目类别：
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/7622209
关键词：
Address Adverse effects Affect Algorithms American Appointment Behavior Budgets Cardiology Caring Case-Control Studies Cessation of life Chronic Disease Chronically Ill Clinic Clinical Clinical Trials Comorbidity Control Groups Cost Analysis Daily Data Diagnosis Discipline of Nursing Edema Education Effectiveness of Interventions End Point Equilibrium Fatigue Goals Guidelines Health Personnel Health Professional Health Services Health Status Healthcare Healthy People 2010 Heart failure Home Nursing Care Home environment Hospitalization Hospitals Individual International Intervention Joint Commission on Accreditation of Healthcare Organizations Knowledge Measures Meta-Analysis Methods Modeling Monitor Nurse Practitioners Nurses Outcome Outpatients Patients Pharmaceutical Preparations Pharmacology Physical Examination Physicians Population Problem Solving Psychological reinforcement Public Health Quality of life Randomized Randomized Clinical Trials Rate Readiness Recommendation Reporting Research Research Personnel Sampling Score Self Care Self Management Series Shortness of Breath Small Business Funding Mechanisms Small Business Innovation Research Grant Specific qualifier value Standards of Weights and Measures Structure Symptoms Tachycardia Telephone Testing Time Translating Upper arm Variant Videotape Weight Gain base college cost cost effectiveness design diaries follow-up functional outcomes health care delivery improved indexing innovation instrument multidisciplinary novel strategies patient home care prevention clinical trial programs satisfaction

项目摘要

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 (Bodenheimer, 2005) 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 1treatment 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.

这项研究的主题是“慢性病的自我管理策略”和 2010 年健康人群目标 12-6 减少心力衰竭住院率。心力衰竭 (HF) 影响 500 万美国人，估计造成的费用每年 288 亿美元。然而，2004 年，只有 31% 的心力衰竭患者接受了基本的 JCAHO- 建议出院教育。公共健康可以通过密集的高频放电和后处理来获得批准医院随访计划。因此，创建了一种结合心力衰竭患者小组诊所的实用干预措施预约/多学科讨论会议和带有患者清单的结构化自我管理日记、算法和电话强化。该干预措施基于美国大学心脏病学国家指南，强调患者自我管理（Bodenheimer，2005）和理想化临床实践的医疗保健改善计划。为了确保研究中的所有患者都我们的高频录像带系列为每个科目提供平等且国家推荐的高频教育（根据 SBIR 1R43AG 生产）。具体目的是测试干预措施对综合的影响主要终点为再住院或死亡，次要终点为卫生服务使用、成本效率、患者健康状况和高频生活质量。还测量了患者的 HF 知识、自我意识管理行为、家庭护理准备、专业人员的参与以及护理的及时性症状报告。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。多元线性混合模型分析将用于测试 12 个月内干预的效果。传统成本分析与创新成本- 效率数据包络分析将用于比较团体干预成本。比较将报告其他 HF 计划的成本。长期目标是改善心力衰竭的自我管理和使用安全、具有成本效益且实用的干预措施及时报告症状。团体诊所预约讨论会支持并让患者参与自我管理（清单日记/症状报告算法），加强他们的 HF 家庭管理并减少整体重新住院率。