BACKGROUND: Disease management programmes for patients with heart failure have improving the quality-of-life (QOL) of patients with heart failure. METHODS:Patients attending the heart failure clinic were randomized into 2 groups of 25 patients each. The control group was managed in the heart failure clinic and the intervention group underwent the following additional interventions: (i) interactive sessions with the patient and spouse informing them about the disease, drugs, and self-management of fluid intake and diuretic dose; (ii) a telephonic helpline was established and regular telephone calls made to reinforce the information and modify drug dosages. The QOL was assessed using the Kansas City Cardiomyopathy questionnaire. Functional capacity was assessed by the 6-minute walk test. Continuous variables were compared with the Student t-test (paired or unpaired). RESULTS: There was significant improvement in the QOL and functional capacity of patients in the intervention group compared with controls over a 6-month period. The mean (SD) QOL scores in the intervention group improved from 60.0 (23.6) to 76.3 (17.3) but did not change significantly in the control group (62.2 [22.6] to 63.4 [21.9]). There was a similar improvement in the functional capacity measured by the 6-minute walk test in the intervention group (from 202.2 [81.5] to 238.1 [100.9] metres, p < 0.05) but not in the control group (193.8 [81.5] to 179.7 [112.0] metres). In the intervention group, the use of beta-blockers and angiotensin-converting enzyme inhibitors was similar but in the intervention group patients were placed on higher doses. There was no significant difference in the number of emergency room visits or admissions in either group. For every 20 patients in the intervention group, 14 patients improved by 1 functional class while in the control group this was observed in only 3 patients for every 20 treated. CONCLUSION: This study demonstrates that in the setting of a developing country, improvement in QOL by intensive management of heart failure patients through a heart failure programme with telephonic reinforcement and a helpline is greater than that usually achieved with drug therapy in a routine heart failure clinic.
RCT Entities:
BACKGROUND: Disease management programmes for patients with heart failure have improving the quality-of-life (QOL) of patients with heart failure. METHODS:Patients attending the heart failure clinic were randomized into 2 groups of 25 patients each. The control group was managed in the heart failure clinic and the intervention group underwent the following additional interventions: (i) interactive sessions with the patient and spouse informing them about the disease, drugs, and self-management of fluid intake and diuretic dose; (ii) a telephonic helpline was established and regular telephone calls made to reinforce the information and modify drug dosages. The QOL was assessed using the Kansas City Cardiomyopathy questionnaire. Functional capacity was assessed by the 6-minute walk test. Continuous variables were compared with the Student t-test (paired or unpaired). RESULTS: There was significant improvement in the QOL and functional capacity of patients in the intervention group compared with controls over a 6-month period. The mean (SD) QOL scores in the intervention group improved from 60.0 (23.6) to 76.3 (17.3) but did not change significantly in the control group (62.2 [22.6] to 63.4 [21.9]). There was a similar improvement in the functional capacity measured by the 6-minute walk test in the intervention group (from 202.2 [81.5] to 238.1 [100.9] metres, p < 0.05) but not in the control group (193.8 [81.5] to 179.7 [112.0] metres). In the intervention group, the use of beta-blockers and angiotensin-converting enzyme inhibitors was similar but in the intervention group patients were placed on higher doses. There was no significant difference in the number of emergency room visits or admissions in either group. For every 20 patients in the intervention group, 14 patients improved by 1 functional class while in the control group this was observed in only 3 patients for every 20 treated. CONCLUSION: This study demonstrates that in the setting of a developing country, improvement in QOL by intensive management of heart failurepatients through a heart failure programme with telephonic reinforcement and a helpline is greater than that usually achieved with drug therapy in a routine heart failure clinic.
Authors: Andrea Beratarrechea; Allison G Lee; Jonathan M Willner; Eiman Jahangir; Agustín Ciapponi; Adolfo Rubinstein Journal: Telemed J E Health Date: 2013-11-08 Impact factor: 3.536
Authors: Natalie M Jayaram; Yevgeniy Khariton; Harlan M Krumholz; Sarwat I Chaudhry; Jennifer Mattera; Fengming Tang; Jeph Herrin; Beth Hodshon; John A Spertus Journal: Circ Cardiovasc Qual Outcomes Date: 2017-12
Authors: Nini H Jonkman; Heleen Westland; Rolf H H Groenwold; Susanna Ågren; Manuel Anguita; Lynda Blue; Pieta W F Bruggink-André de la Porte; Darren A DeWalt; Paul L Hebert; Michele Heisler; Tiny Jaarsma; Gertrudis I J M Kempen; Marcia E Leventhal; Dirk J A Lok; Jan Mårtensson; Javier Muñiz; Haruka Otsu; Frank Peters-Klimm; Michael W Rich; Barbara Riegel; Anna Strömberg; Ross T Tsuyuki; Jaap C A Trappenburg; Marieke J Schuurmans; Arno W Hoes Journal: J Card Fail Date: 2016-06-30 Impact factor: 5.712
Authors: William Speier; Eldin Dzubur; Mary Zide; Chrisandra Shufelt; Sandy Joung; Jennifer E Van Eyk; C Noel Bairey Merz; Mayra Lopez; Brennan Spiegel; Corey Arnold Journal: J Am Med Inform Assoc Date: 2018-10-01 Impact factor: 7.942