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.

这项研究涉及“跨慢性疾病的自我管理策略”和健康人2010 目标12-6减少HF住院治疗。心力衰竭（HF）影响500万美国人，估计成本每年288亿美元。然而，在2004年，只有31％的HF患者甚至接受了基本的JCAHO- 建议出院教育。公共卫生可以通过密集的HF出院和后批准医院后续计划。因此，创建了将HF患者组诊所结合在一起的实际干预措施约会/多学科讨论会议和结构化自我管理与患者清单日记，算法和电话加固。干预措施基于美国学院心脏病学国家准则，强调患者自我管理（Bodenheimer，2005年）和医疗保健改进计划，用于理想化的临床实践。确保研究中的所有患者我们的HF录像带系列提供了平等和全国推荐的HF教育，每个主题均提供（在SBIR 1R43AG下生产）。具体目的是测试干预对复合材料的影响卫生服务使用的重新住院或死亡和次要终点的主要终点效率，患者健康状况和HF生活质量。还测量的是患者HF知识，自我管理行为，为家庭护理做好准备，与专业人员的参与以及及时性症状报告。这是一项具有1次治疗和1个标准护理（对照）组的随机临床试验。每组将有92例HF患者，总样本为n = 184。多元线性混合模型分析将是用于测试12个月内干预的影响。传统的成本分析和创新成本 - 效率数据包络分析将用于比较小组干预成本。比较将报告其他HF计划的费用。长期目标是改善HF自我管理和及时使用安全，成本效益和实用的干预措施来报告症状。小组诊所与讨论会议的约会支持并让患者参与自我管理（清单日记/症状报告算法），加强其HF家庭管理并减少总体重新住院率。