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  • A multidisciplinary, home based intervention reduced deaths and readmissions in patients with chronic congestive heart failure

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Therapeutics
A multidisciplinary, home based intervention reduced deaths and readmissions in patients with chronic congestive heart failure

https://doi.org/10.1136/ebm.5.3.84

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    (1999) Lancet 354, 1077. Stewart S, Marley JE, Horowitz JD.. Effects of a multidisciplinary, home-based intervention on unplanned readmissions and survival among patients with chronic congestive heart failure: a randomised controlled study.. Sep 25;. :. –83.
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 QUESTION: In patients with chronic congestive heart failure (CHF) who are discharged to their homes after acute hospital admission, can a multidisciplinary, home based intervention reduce out of hospital deaths and unplanned readmissions?

    Design

    Randomised (allocation concealed*), blinded (outcome assessor),* controlled trial with 6 month follow up.

    Setting

    A tertiary referral hospital in Adelaide, South Australia, Australia.

    Patients

    200 patients ≥55 years of age (mean age 76 y, 62% men) who were to be discharged to their homes, had CHF, and had ≥1 previous hospital admission for acute CHF. Exclusion criteria were extensive reversible ischaemia that precipitated heart failure, valvular heart disease amenable to surgery, intended heart transplantation, terminal illness, or residence outside of the catchment area. Follow up was complete.

    Intervention

    100 patients were allocated to usual care only (appointment with primary care physician or outpatient clinic …

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    Footnotes

    • Source of funding: not stated.

    • For correspondence: Professor JD Horowitz, Department of Cardiology, Queen Elizabeth Hospital, 28 Woodville Road, Woodville, South Australia 5011, Australia. Fax +61 8 8222-6030.

    • ↵* See glossary.

    • †p value calculated from data in article.