Chan, Y., Stewart, S., Calderone, A., Scuffham, P., Goldstein, S. & Carrington, MJ. (2012). 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. International Journal of Cardiology,154(1), 52-58. Ireland: Elsevier Ireland Ltd. Retrieved from https://doi.org/10.1016/j.ijcard.2010.08.071
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 ± 3.9 kg/m2) and 66% had an elevated blood pressure (153 ± 18/89 ± 7 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.
Mary MacKillop Institute for Health Research
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