Anu Philip, Chakrakodi Shasidhara Shastry, Basavaraj Utagi, Anjusha Alex
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引用次数: 0
Abstract
Background: Disease management programs for heart failure (HF) often include various strategies such as medication management and lifestyle modifications, and are known to improve clinical outcomes.
Objectives: To evaluate the effectiveness of an individualized patient education program (IPEP) specifically designed for patients with reduced ejection fraction (HFrEF) on clinical outcomes.
Methods: In our prospective interventional study involving 164 patients, participants were divided into control (CG) and intervention (IG) groups. The IG received the IPEP facilitated by the academic pharmacist, while both the IG and the CG continued to receive standard care from the healthcare team without any differences in the care provided. Self-care practices, medication adherence, quality of life, and clinical outcomes were assessed at both the 6th and 12th months. Statistical analysis included Chi-square tests, Kaplan-Meier survival plots, and Multivariable Cox proportional regression analysis. Data analysis was conducted using JAMOVI and R software.
Results: The demographic and clinical characteristics of sample population were largely homogeneous in both the groups. The unadjusted 1-year rehospitalization (RH) rate was significantly lower in the IG at 33 % compared to 48 % in the CG, with a hazard ratio of 0.55 (95 % CI: 0.34-0.90, p = 0.018). Kaplan-Meier survival analysis depicts a higher RH rate for HFrEF participants over time, with a significant difference observed between CG and IG (log-rank P = 0.017). Notable disparities in self-care practices emerged & at the 6th and 12th-month assessments medication adherence & QoL were significantly improved in the IG (p ≤ 0.001).
Conclusion: IPEP led by an academic pharmacist resulted in improved self-care practices, enhanced quality of life, and reduced one-year rehospitalization rates.
背景：心力衰竭（HF）的疾病管理方案通常包括各种策略，如药物管理和生活方式改变，并且已知可以改善临床结果。目的：评估专为射血分数降低（HFrEF）患者设计的个体化患者教育计划（IPEP）对临床结果的有效性。方法：在164例患者的前瞻性介入研究中，将参与者分为对照组（CG）和干预组（IG）。IG接受了由学术药剂师协助的IPEP，而IG和CG继续接受医疗团队的标准护理，所提供的护理没有任何差异。在第6个月和第12个月对自我保健实践、药物依从性、生活质量和临床结果进行评估。统计分析包括卡方检验、Kaplan-Meier生存图和多变量Cox比例回归分析。采用JAMOVI和R软件进行数据分析。结果：两组样本人口的人口学和临床特征基本相同。IG组未经调整的1年再住院率（RH）为33%，显著低于CG组的48%，风险比为0.55 （95% CI: 0.34-0.90, p = 0.018）。Kaplan-Meier生存分析显示，随着时间的推移，HFrEF参与者的RH率更高，在CG和IG之间观察到显著差异（log-rank P = 0.017）。在自我护理实践方面出现了显著差异，在第6个月和第12个月评估时，IG组的药物依从性和生活质量显著改善（p≤0.001）。结论：由学术药剂师领导的IPEP改善了自我保健实践，提高了生活质量，降低了一年再住院率。
期刊介绍：
Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders.
The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.
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