PDF(Pubmed)
Abstract：
Ambulatory management of congestive heart failure (HF) continues to be a challenging clinical problem. Recent studies have focused on the role of HF clinics, nurse practitioners and disease management programmes to reduce HF readmissions. This pilot study is a pragmatic factorial study comparing a coach intervention, a SMARTPHONE REMINDER system intervention and BOTH interventions combined to Treatment as USUAL (TAU). We determined that both modalities were acceptable to patients prior to randomisation. Fifty-four patients were randomised to the four groups. The COACH group had no readmissions for HF 6 months after enrolment compared with 18% for the SMARTPHONE REMINDER Group, 8% for the BOTH intervention group and 13% for TAU. Medium-to-high medication adherence was maintained in all four groups although sodium consumption was lower at 3 months for the COACH and combined (BOTH) groups. This pilot study suggests a beneficial effect on rehospitalisation with the use of support measures including coaches and telephone reminders that needs confirmation in a larger trial.
摘要：
充血性心力衰竭（HF）的动态管理仍然是一个具有挑战性的临床问题。最近的研究集中在HF诊所的作用，护士从业人员和疾病管理计划，以减少HF再入院。这项试点研究是一项比较教练干预的务实因素研究，智能手机提醒系统干预和两种干预措施结合治疗作为常规（TAU）。我们确定在随机化之前两种方式对患者都是可接受的。54名患者被随机分为四组。COACH组在入组6个月后未再入院，而SMARTPHONEREMINDER组则为18%。两者干预组为8%，TAU组为13%。尽管COACH和联合（两者）组的钠消耗量在3个月时较低，但所有四组均保持了中等至高的药物依从性。这项初步研究表明，使用支持措施，包括教练和电话提醒，需要在更大的试验中确认，对再住院有有益的影响。
