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Post-discharge home-based support for older cardiac patients: a randomised controlled trial
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UNSPECIFIED (2005) Post-discharge home-based support for older cardiac patients: a randomised controlled trial. AGE AND AGEING, 34 (4). pp. 338-343. doi:10.1093/ageing/afi116 ISSN 0002-0729.
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Official URL: http://dx.doi.org/10.1093/ageing/afi116
Abstract
Background: hospital and exercise-based cardiac rehabilitation programmes do not suit many older patients and home-based rehabilitation may be more effective.
Objective: to evaluate a home-based intervention for patients aged 65 years or over discharged home from hospital after emergency admission for suspected myocardial infarction.
Design: a single-blind randomised controlled trial comparing home-based intervention by a nurse with usual care.
Subjects: patients aged 65 years or over discharged home after hospitalisation with suspected myocardial infarction (n=324).
Intervention: home-based intervention (n = 163) consisted of home visits at 1-2 and 6-8 weeks after hospital discharge by a nurse who encouraged compliance with and knowledge of their treatment regimen, offered support and guidance about resuming daily activities, and involved other community services as appropriate.
Measurements: up to 100 days after admission, data were collected on deaths, hospital readmissions and use of outpatient services. Survivors were sent a postal questionnaire to assess activities of daily living and quality of life.
Results: at 100 day follow-up there was no difference in deaths, activities of daily living or overall quality of life, but those in the intervention group scored significantly better on the confidence and self-esteem subsections. The intervention group had fewer hospital readmissions (35 versus 51, relative risk 0.68, 95% Cl 0.47-0.98, P<0.05) and fewer days of hospitalisation after initial discharge (mean difference -1.7, 95% CI -2.09 to -1.31, P<0.05). A total of 42/43 individuals in the intervention group had resumed driving at follow-up, compared with 32/43 in the usual care group (observed difference between proportions 23%, 95% CI 9-37%, P<0.05).
Conclusion: amongst older patients discharged home after hospitalisation for suspected myocardial infarction, home-based nurse intervention may improve confidence and self-esteem, and reduce early hospital readmissions.
Item Type: | Journal Article | ||||
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Journal or Publication Title: | AGE AND AGEING | ||||
Publisher: | OXFORD UNIV PRESS | ||||
ISSN: | 0002-0729 | ||||
Official Date: | July 2005 | ||||
Dates: |
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Volume: | 34 | ||||
Number: | 4 | ||||
Number of Pages: | 6 | ||||
Page Range: | pp. 338-343 | ||||
DOI: | 10.1093/ageing/afi116 | ||||
Publication Status: | Published |
Data sourced from Thomson Reuters' Web of Knowledge
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