Effect of home-based intervention on hospital readmission and quality of life in middle-aged patients with severe congestive heart failure: a 12-month follow up study.

摘要

OBJECTIVE: Home care surveillance has been shown to reduce hospital readmission and improve functional status and quality of life of elderly patients with mild to moderate or severe congestive heart failure and in younger patients candidates for transplantation. The present study aimed to investigate the effect of home-based intervention on hospital readmission and quality of life of middle-aged patients with severe congestive heart failure. METHODS: Thirty-three patients aged 50-75 (mean age 65.4+/-6.7) with class III and IV congestive heart failure were included in this observational, community-based study. Intervention consisted of intensive home surveillance of patients, including frequent home visits associated with laboratory tests and telephone contacts to implement standard therapy, treat early symptoms and provide psychological support. RESULTS: Admissions for cardiovascular reasons decreased from 2.143+/-1.11 for the year before the initiation of the study to 1.25+/-1 after its completion (P=0.0005). Quality of life improved, as showed by a decrease of the mean score of the Minnesota Living with Heart Failure Questionnaire from 2.68+/-0.034 to 2.33+/-0.032 (P=0.0001). CONCLUSION: Intensive home care of middle-aged patients with severe heart failure results in improved quality of life and a decrease in hospital readmission rates.