Domingo Cristina, Aros Fernando, Otxandategi Agurtzane, Beistegui Idoia, Besga Ariadna, Latorre Pedro María
Medicina Familiar y Comunitaria, Gerencia de Atención Primaria del Servicio Cántabro de Salud, Santander, España.
Hospital Universitario de Araba, Osakidetza, Araba, España; Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y de la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, España.
Aten Primaria. 2019 Mar;51(3):142-152. doi: 10.1016/j.aprim.2017.09.011. Epub 2018 Feb 26.
To assess the efficacy of the ProMIC, multidisciplinary program for patients admitted at hospital because of heart failure (HF) programme, in reducing the HF-related readmission rate.
Quasi-experimental research with control group.
Twelve primary health care centres and 3 hospitals from the Basque Country.
Aged 40 years old or above patients admitted for HF with a New York Heart Association functional class II to IV.
Patients in the intervention group carried out the ProMIC programme, a structured clinical intervention based on clinical guidelines and on the chronic care model. Control group received usual care.
The rate of readmission for HF and health-related quality of life RESULTS: One hundred fifty five patients were included in ProMIC group and 129 in control group. 45 rehospitalisation due to heart failure happened in ProMIC versus 75 in control group (adjusted hazard ratio=0.59, CI 95%: 0.36-0.98; P=.049). There were significant differences in specific quality of life al 6 months. No significant differences were found in rehospitalisation due to all causes, due to cardiovascular causes, visits to emergency room, mortality, the combined variable of these events, the functional capacity or quality of life at 12 months of follow up.
ProMIC reduces significantly heart failure rehospitalisation and improve quality of life al 6 months of follow up. No significant differences were found in the rests of variables.
评估针对因心力衰竭（HF）入院患者的多学科ProMIC项目在降低HF相关再入院率方面的疗效。
设有对照组的准实验研究。
来自巴斯克地区的12个初级卫生保健中心和3家医院。
年龄在40岁及以上、因HF入院且纽约心脏协会心功能分级为II至IV级的患者。
干预组患者实施ProMIC项目，这是一项基于临床指南和慢性病护理模式的结构化临床干预。对照组接受常规护理。
HF再入院率和健康相关生活质量。
ProMIC组纳入155例患者，对照组纳入129例患者。ProMIC组因心力衰竭再次住院45例，对照组为75例（调整后风险比=0.59，95%置信区间：0.36 - 0.98；P = 0.049）。6个月时特定生活质量存在显著差异。在随访12个月时，因各种原因、心血管原因导致的再入院、急诊室就诊次数、死亡率、这些事件的综合变量、功能能力或生活质量方面未发现显著差异。
ProMIC显著降低心力衰竭再入院率，并在随访6个月时改善生活质量。在其余变量方面未发现显著差异。
