Azad Nahid, Molnar Frank, Byszewski Anna
The Geriatric Assessment Inpatient Unit, The Ottawa Hospital, Ottawa, Ontario, K1Y 4E9, Canada.
Age Ageing. 2008 May;37(3):282-7. doi: 10.1093/ageing/afn013. Epub 2008 Feb 18.
many heart failure disease management programs are primarily conducted in the male population. An approach incorporating disciplines such as physiotherapy, occupational therapy, social work, dietary and pharmacy in a standardized clinical pathway merits further investigation in older women with HF.
in this randomized controlled trial, female patients in the intervention group received the multidisciplinary clinical pathway consisting of a series of 12 visits over a 6-week period in an outpatient clinic.
ninety-one community dwelling female patients aged 63 to 89 were randomized. Comparison of change between the two groups from baseline in the Minnesota Living with Heart Failure Questionnaire score did not show a difference (P<0.470). There was also no difference between the two groups in functional outcome as measured by change from baseline by the Physical Self-Maintenance Scale (P<0.321). The treatment group had significantly more hospitalizations, and cardiologist visits during the study period (P < 0.0001).
It is feasible to conduct a randomized study in a frail community-based older female population and to test a complex multidisciplinary pathway. Future studies should provide insight into the optimal intensity and duration of heart failure management programs with optimal targeting.
许多心力衰竭疾病管理项目主要在男性群体中开展。一种将物理治疗、职业治疗、社会工作、饮食和药学等学科纳入标准化临床路径的方法，值得在老年女性心力衰竭患者中进一步研究。
在这项随机对照试验中，干预组的女性患者接受了多学科临床路径，包括在门诊6周内进行一系列12次就诊。
91名年龄在63至89岁的社区居住女性患者被随机分组。两组在明尼苏达心力衰竭生活问卷评分上从基线开始的变化比较没有显示出差异（P<0.470）。通过身体自我维持量表从基线开始的变化衡量的功能结局在两组之间也没有差异（P<0.321）。治疗组在研究期间的住院次数和心脏病专家就诊次数明显更多（P<0.0001）。
在体弱的社区老年女性群体中进行随机研究并测试复杂的多学科路径是可行的。未来的研究应该深入了解心力衰竭管理项目的最佳强度和持续时间以及最佳目标人群。
