Randomized clinical trial of the effectiveness of a home-based intervention in patients with heart failure: the IC-DOM study.
OBJECTIVE
The objective of this study was to determine whether a home-based intervention can reduce mortality and hospital readmissions and improve quality of life in patients with heart failure.


METHODS
A randomized clinical trial was carried out between January 2004 and October 2006. In total, 283 patients admitted to hospital with a diagnosis of heart failure were randomly allocated to a home-based intervention (intervention group) or usual care (control group). The primary end-point was the combination of all-cause mortality and hospital readmission for worsening heart failure at 1-year follow-up.


RESULTS
The primary end-point was observed in 41.7% of patients in the intervention group and in 54.3% in the control group. The hazard ratio was 0.70 (95% confidence interval [CI] 0.55-0.99). Taking significant clinical variables into account slightly reduced the hazard ratio to 0.62 (95% CI 0.50-0.87). At the end of the study, the quality of life of patients in the intervention group was better than in the control group (18.57 vs. 31.11; P< .001).


CONCLUSIONS
A home-based intervention for patients with heart failure reduced the aggregate of mortality and hospital readmissions and improved quality of life.
Brotons
Carlos
C
Unidad de Investigación, Equipo de Atención Primaria Sardenya, Sardenya 466, Barcelona 08025, Spain. cbrotons@eapsardenya.cat
Falces
Carles
C
Alegre
José
J
Ballarín
Elena
E
Casanovas
Jordi
J
Catà
Teresa
T
Martínez
Mireia
M
Moral
Irene
I
Ortiz
Jacint
J
Pérez
Eulàlia
E
Rayó
Elisabet
E
Recio
Jesús
J
Roig
Eulàlia
E
Vidal
Xavier
X
D000368:Aged; D018450:Disease Progression; D023381:Endpoint Determination; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000401:mortality / Q000523:psychology / Q000628:therapy*; D006699:Home Care Services; D006760:Hospitalization; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D011788:Quality of Life