Congestive heart failure is the most common indication for admission to the hospital among older adults.
Behavioral factors, such as poor compliance with treatment, frequently contribute to exacerbations of heart failure, a fact suggesting that many admissions could be prevented.
We conducted a prospective, randomized trial of the effect of a nurse-directed, multidisciplinary intervention on rates of readmission within 90 days of hospital discharge, quality of life, and costs of care for high-risk patients 70 years of age or older who were hospitalized with congestive heart failure.
The intervention consisted of comprehensive education of the patient and family, a prescribed diet, social-service consultation and planning for an early discharge, a review of medications, and intensive follow-up.
Survival for 90 days without readmission, the primary outcome measure, was achieved in 91 of the 142 patients in the treatment group, as compared with 75 of the 140 patients in the control group, who received conventional care (P=0.09).
There were 94 readmissions in the control group and 53 in the treatment group (risk ratio, 0.56 ; P=0.02).
A nurse-directed, multidisciplinary intervention can improve quality of life and reduce hospital use and medical costs for elderly patients with congestive heart failure.
Mots-clés Pascal : Insuffisance cardiaque, Hospitalisation, Surveillance population, Coût, Etats Unis, Amérique du Nord, Amérique, Prévention, Traitement, Vieillard, Homme, Essai thérapeutique contrôlé, Multidisciplinaire, Récidive, Appareil circulatoire pathologie, Cardiopathie, Gériatrie
Mots-clés Pascal anglais : Heart failure, Hospitalization, Population survey, Costs, United States, North America, America, Prevention, Treatment, Elderly, Human, Controlled therapeutic trial, Multidisciplinary, Relapse, Cardiovascular disease, Heart disease, Geriatrics
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0003118
Code Inist : 002B12A01. Création : 01/03/1996.