RESICARD, Heart Failure Network, 75011 Paris, France.
Department of Cardiology, Saint-Antoine and Tenon Hospitals, AP-HP, Sorbonne Université, 75012 Paris, France.
Arch Cardiovasc Dis. 2024 Oct;117(10):561-568. doi: 10.1016/j.acvd.2024.04.006. Epub 2024 Jul 4.
Heart failure is associated with reduced quality of life, hospitalizations, death and high healthcare costs. Despite care improvements, the rehospitalization rate after an acute heart failure episode, especially for acute heart failure, remains high.
The Education Strategy for patients with acute Heart Failure (EduStra-HF; ClinicalTrials.gov Identifier NCT03035123) study will randomize patients admitted for acute heart failure in six French hospitals to usual care (control) or therapeutic education (intervention). All patients will be evaluated at baseline and will meet with a therapeutic education nurse before discharge. Those in the usual care arm will have standard appointments with their cardiologist and general practitioner. Those in the intervention arm will have an intensive follow-up schedule of phone calls, home visits and text messages from the therapeutic education nurses, plus cardiologist visits. Patients will be stratified by discharge location (home or cardiac rehabilitation centre) before randomization, and will be followed up for 1 year. The primary outcome will be the readmission rates for acute heart failure during 1 year in the two groups. Secondary outcomes will include: quality of life; time from inclusion to first readmission for acute heart failure; non-heart failure cardiovascular rehospitalization rates; length of stay for heart failure; cardiovascular and all-cause death; rates of patients receiving optimal medical therapies; evolution of knowledge about heart failure; and cost-effectiveness.
This study will assess the efficacy and feasibility of a standardized management strategy for the care and follow-up of patients discharged after hospitalization for acute heart failure. The EduStra-HF strategy will combine various nurse care methods to help prevent rehospitalization.
心力衰竭与生活质量降低、住院治疗、死亡和高医疗成本相关。尽管护理有所改善，但急性心力衰竭发作后再次住院的比率仍然很高，尤其是急性心力衰竭患者。
急性心力衰竭患者教育策略（EduStra-HF；ClinicalTrials.gov 标识符 NCT03035123）研究将随机选择六家法国医院因急性心力衰竭入院的患者接受常规护理（对照组）或治疗教育（干预组）。所有患者将在基线时进行评估，并在出院前与治疗教育护士会面。对照组患者将与心脏病专家和全科医生进行标准预约。干预组患者将接受治疗教育护士的密集随访计划，包括电话、家访和短信，以及心脏病专家就诊。在随机分组前，将根据出院地点（家庭或心脏康复中心）对患者进行分层，并随访 1 年。主要结局为两组 1 年内因急性心力衰竭再次住院的比率。次要结局包括：生活质量；从纳入到首次因急性心力衰竭再次住院的时间；非心力衰竭心血管再次住院的比率；心力衰竭住院时间；心血管和全因死亡；接受最佳药物治疗的患者比例；心力衰竭知识的演变；以及成本效益。
这项研究将评估一种标准化管理策略用于急性心力衰竭住院后患者护理和随访的疗效和可行性。EduStra-HF 策略将结合各种护士护理方法，以帮助预防再次住院。
