BACKGROUND: A disease management program can reduce mortality and rehospitalization of patients with heart failure (HF), but little is known about whether it can improve psychological status. The purpose of this study was to determine the effects of home-based disease management on the psychological status of patients with HF. METHODS AND RESULTS: We randomly assigned patients hospitalized for HF to undergo either home-based disease management (n=79) or usual care (n=82). The mean age of the study patients was 76 years, 30% were female, and 93% were in NYHA class I or II. Home-based disease management was delivered by nurses via home visit and telephone follow-up to monitor symptoms and body weight and to educate patients. The primary endpoint was psychological status, including depression and anxiety assessed by the Hospital Anxiety and Depression Scale during follow-up of 1 year. Secondary endpoints included quality of life, all-cause death and hospitalization for HF. The intervention group had significantly lower depression (P=0.043) and anxiety (P=0.029) scores than the usual-care group. There were no significant differences in all-cause death [hazard ratio (HR) 1.02, 95% confidence interval (CI) 0.37-2.61, P=0.967]. However, hospitalization for HF was significantly lower in the intervention group than in the usual-care group (HR 0.52, 95% CI 0.27-0.96, P=0.037). CONCLUSIONS:Home-based disease management improved psychological status and also reduced rehospitalization for HF in patients with HF.
RCT Entities:
BACKGROUND: A disease management program can reduce mortality and rehospitalization of patients with heart failure (HF), but little is known about whether it can improve psychological status. The purpose of this study was to determine the effects of home-based disease management on the psychological status of patients with HF. METHODS AND RESULTS: We randomly assigned patients hospitalized for HF to undergo either home-based disease management (n=79) or usual care (n=82). The mean age of the study patients was 76 years, 30% were female, and 93% were in NYHA class I or II. Home-based disease management was delivered by nurses via home visit and telephone follow-up to monitor symptoms and body weight and to educate patients. The primary endpoint was psychological status, including depression and anxiety assessed by the Hospital Anxiety and Depression Scale during follow-up of 1 year. Secondary endpoints included quality of life, all-cause death and hospitalization for HF. The intervention group had significantly lower depression (P=0.043) and anxiety (P=0.029) scores than the usual-care group. There were no significant differences in all-cause death [hazard ratio (HR) 1.02, 95% confidence interval (CI) 0.37-2.61, P=0.967]. However, hospitalization for HF was significantly lower in the intervention group than in the usual-care group (HR 0.52, 95% CI 0.27-0.96, P=0.037). CONCLUSIONS: Home-based disease management improved psychological status and also reduced rehospitalization for HF in patients with HF.
Authors: Benjamin Hon Kei Yip; Eric Kam Pui Lee; Regina Wing Shan Sit; Carmen Wong; Xue Li; Eliza Lai Yi Wong; Martin Chi Sang Wong; Roger Yat Nork Chung; Vincent Chi Ho Chung; Kenny Kung; Samuel Yeung Shan Wong Journal: Sci Rep Date: 2018-07-09 Impact factor: 4.379