Exploring the potential to remain “Young @ Heart”: Initial findings of a multi-centre, randomised study of nurse-led, home-based intervention in a hybrid health care system
Author(s)
Chan, Yih-Kai
Stewart, Simon
Calderone, Alicia
Scuffham, Paul
Goldstein, Stan
Carrington, Melinda J
Griffith University Author(s)
Year published
2012
Metadata
Show full item recordAbstract
Background Disease management programs have been shown to improve health outcomes in high risk individuals in many but not all health care systems. Methods Young @ Heart is a multi-centre, randomised controlled study of a nurse-led, home-based intervention (HBI) program vs. usual care (UC) in privately insured patients in Australia aged = 45 years following an acute cardiac admission. Intensity of HBI is tailored to an individual's clinical stability, management and risk profile. The primary endpoint is the rate of all-cause stay during a mean of 2.5 years follow-up. Results A target of 602 adults (72% men) were randomised ...
View more >Background Disease management programs have been shown to improve health outcomes in high risk individuals in many but not all health care systems. Methods Young @ Heart is a multi-centre, randomised controlled study of a nurse-led, home-based intervention (HBI) program vs. usual care (UC) in privately insured patients in Australia aged = 45 years following an acute cardiac admission. Intensity of HBI is tailored to an individual's clinical stability, management and risk profile. The primary endpoint is the rate of all-cause stay during a mean of 2.5 years follow-up. Results A target of 602 adults (72% men) were randomised to HBI (n = 306) or UC (n = 296); their initial profiles being well matched. At baseline, 71% were overweight (body mass index 29.7 ᠳ.9 kg/m2) and 66% had an elevated blood pressure (153 ᠱ8/89 ᠷ mm Hg). Over half had a history of smoking and 39% had a sub-optimal total cholesterol level > 4 mmol/L. Overall, 62% (376 cases) were treated for coronary artery disease (27% with multi-vessel disease and 39% underwent cardiac revascularisation). A further 20% (120 cases) were treated for a cardiac arrhythmia (predominantly atrial fibrillation) and 19% type 2 diabetes mellitus. At 7-14 days post-discharge, 293 (96%) HBI patients received a home visit triggering urgent clinical review and/or enhanced clinical management in many patients. Conclusions The Young @ Heart intervention is a well accepted and potentially effective intervention to reduce recurrent hospital stay in privately insured cardiac patients in Australia.
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View more >Background Disease management programs have been shown to improve health outcomes in high risk individuals in many but not all health care systems. Methods Young @ Heart is a multi-centre, randomised controlled study of a nurse-led, home-based intervention (HBI) program vs. usual care (UC) in privately insured patients in Australia aged = 45 years following an acute cardiac admission. Intensity of HBI is tailored to an individual's clinical stability, management and risk profile. The primary endpoint is the rate of all-cause stay during a mean of 2.5 years follow-up. Results A target of 602 adults (72% men) were randomised to HBI (n = 306) or UC (n = 296); their initial profiles being well matched. At baseline, 71% were overweight (body mass index 29.7 ᠳ.9 kg/m2) and 66% had an elevated blood pressure (153 ᠱ8/89 ᠷ mm Hg). Over half had a history of smoking and 39% had a sub-optimal total cholesterol level > 4 mmol/L. Overall, 62% (376 cases) were treated for coronary artery disease (27% with multi-vessel disease and 39% underwent cardiac revascularisation). A further 20% (120 cases) were treated for a cardiac arrhythmia (predominantly atrial fibrillation) and 19% type 2 diabetes mellitus. At 7-14 days post-discharge, 293 (96%) HBI patients received a home visit triggering urgent clinical review and/or enhanced clinical management in many patients. Conclusions The Young @ Heart intervention is a well accepted and potentially effective intervention to reduce recurrent hospital stay in privately insured cardiac patients in Australia.
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Journal Title
International Journal of Cardiology
Volume
154
Issue
1
Subject
Cardiorespiratory Medicine and Haematology not elsewhere classified
Cardiorespiratory Medicine and Haematology
Public Health and Health Services