Randomized Clinical Trial of the Effectiveness of a Home-Based Intervention in Patients With Heart Failure: The IC-DOM Study

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• 作者：Carlos Brotons ; Carles Falces ; José ; Alegre ; Elena Ballarí ; n ; Jordi Casanovas ; Teresa Catà ; Mireia Martí ; nez ; Irene Moral ; Jacint Ortiz ; Eulà ; lia Pé ; rez ; Elisabet Ray&#xf3 ; Jes&#xfa ; s Recio ; Eulà ; lia Roig ; Xavier Vidal
• 关键词：Heart failure ; Hospital readmission ; Mortality ; Quality of life
• 刊名：Revista Española de Cardiología (English Edition)
• 出版年：2009
• 出版时间：April 2009
• 年：2009
• 卷：62
• 期：4
• 页码：400-408
• 全文大小：225 K

文摘

Introduction and objectives

The objective of this study was to determine whether a home-based intervention can reduce mortality and hospital readmissions and improve quality of life in patients with heart failure.

Methods

A randomized clinical trial was carried out between January 2004 and October 2006. In total, 283 patients admitted to hospital with a diagnosis of heart failure were randomly allocated to a home-based intervention (intervention group) or usual care (control group). The primary end-point was the combination of allcause mortality and hospital readmission for worsening heart failure at 1-year follow-up.

Results

The primary end-point was observed in 41.7 % of patients in the intervention group and in 54.3 % in the control group. The hazard ratio was 0.70 (95 % confidence interval [CI], 0.55-0.99). Taking significant clinical variables into account slightly reduced the hazard ratio to 0.62 (95 % CI, 0.50-0.87). At the end of the study, the quality of life of patients in the intervention group was better than in the control group (18.57 vs 31.11; P<.001).

Conclusions

A home-based intervention for patients with heart failure reduced the aggregate of mortality and hospital readmissions and improved quality of life.