[Evaluation of a home-based intervention in heart failure patients. Results of a randomized study].
OBJECTIVE
Home-based interventions after hospital discharge in patients with heart failure (HF) have been shown to decrease readmission and mortality rates. The primary aim of this study was to determine the effect of a home-based educational intervention carried out by nursing staff on the readmission rate, emergency department visits, and healthcare costs.


METHODS
Patients hospitalized with systolic HF were randomly assigned to receive either usual care or a single home-based educational intervention 1 week after discharge.


RESULTS
Between July 2001 and November 2002, 70 patients entered the study: 34 in the intervention group and 36 in the control group. During the 6-month follow-up, there were fewer unplanned readmissions in the intervention group than in the control group (0.09 vs 0.94; P<.001), fewer emergency department visits (0.21 vs 1.33; P<.001), and fewer out-of-hospital deaths (2 vs 11; P<.01). Costs were also significantly lower in the intervention group (difference, ; 1190.9; P<.001). Moreover, patient-perceived health status, as indicated by scores on a quality-of-life questionnaire, increased significantly in the intervention group.


CONCLUSIONS
In a cohort of patients with systolic HF who received a home-based educational intervention there were significant reductions in the unplanned readmission rate, mortality, and healthcare costs, and better quality of life. Some limitations of the study warrant validation of the resultats in further studies.
Morcillo
Cèsar
C
Servicio de Medicina Interna, Hospital Sagrat Cor, Barcelona, Spain. 32379cms@comb.es
Valderas
José M
JM
Aguado
Ofelia
O
Delás
Jordi
J
Sort
Dolors
D
Pujadas
Ramón
R
Rosell
Francesc
F
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000191:economics / Q000401:mortality / Q000628:therapy*; D006699:Home Care Services / Q000191:economics; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors