Ibsen Charlotte, Katholm Kirstine Kold, Jakobsen Anja, Eriksen Gitte Bastrup, Lysdal Lene, Nielsen Ulla Kirkegård, Ravn Maiken Bay, Maribo Thomas
DEFACTUM, Central Denmark Region, Aarhus, Denmark.
Department of Public Health, Aarhus University, Aarhus, Denmark.
BMC Health Serv Res. 2024 Dec 18;24(1):1579. doi: 10.1186/s12913-024-12073-x.
Despite advancements in reducing cardiovascular disease, it remains a major health concern. Cardiac rehabilitation (CR) has a positive impact on morbidity, mortality, and functioning, but faces high dropout rates especially among vulnerable patients, due to social inequalities and insufficiently tailored interventions. To address this, we developed the Heart Priority Programme targeting and supporting cardiac patients at risk of dropout. This study outlines the development of the Heart Priority Programme and share findings from a feasibility test.
An iterative three-stage process involving cardiac patients and healthcare professionals from three community healthcare services, guided the development of the programme. Stage 1 included reviewing evidence, consulting stakeholders, and observing practice. In stage 2, a project-group of researchers and healthcare professionals was established to co-produce the programme. Stage 3 included field-testing and local adaptions. Subsequently, the programme was feasibility tested in a single-arm follow-up study across two community healthcare services. Over six months, process data on implementation, acceptability, and mechanism of impact were gathered.
The Heart Priority Programme was development from January 2023 to June 2023, comprising two main parts: 1) an evidence-based identification form with 13 risk factors to identify patients at risk of dropout (referred to as priority patients), and 2) an add-on intervention targeted these patients with three core elements-assigning a contact person, systematic communication, and follow-up. During a six-month feasibility phase, 260 patients were included. Of these, 91 (35%) were identified as priority patients. CR teams found that the programme was relevant, easy to integrate into daily workflow, and applicable in practice. Patient consultations yielded positive feedback on the three core elements of the add-on intervention.
This paper outlines the development and feasibility test of the Heart Priority Programme, co-produced to identify, and support priority patients. The programme, developed through a three-stage iterative co-production process, was found relevant and easy to implement in community healthcare services. CR teams valued its structured approach to supporting priority patients, and patients found it aligned with their needs. Although initial results are promising, further research is needed to evaluate the programme's effectiveness and suitability for widespread implementation.
ClinicalTrials.gov NCT06575764, registered retrospectively on 28 August 2024.
尽管在降低心血管疾病方面取得了进展，但它仍然是一个主要的健康问题。心脏康复（CR）对发病率、死亡率和功能有积极影响，但由于社会不平等和干预措施针对性不足，面临着高退出率，尤其是在脆弱患者中。为了解决这个问题，我们制定了“心脏优先计划”，以针对并支持有退出风险的心脏病患者。本研究概述了“心脏优先计划”的制定过程，并分享了可行性测试的结果。
一个涉及来自三个社区医疗服务机构的心脏病患者和医疗保健专业人员的三阶段迭代过程指导了该计划的制定。第一阶段包括审查证据、咨询利益相关者和观察实践。在第二阶段，成立了一个由研究人员和医疗保健专业人员组成的项目组来共同制定该计划。第三阶段包括现场测试和本地化调整。随后，该计划在一项针对两个社区医疗服务机构的单臂随访研究中进行了可行性测试。在六个月的时间里，收集了关于实施、可接受性和影响机制的过程数据。
“心脏优先计划”于2023年1月至2023年6月制定，包括两个主要部分：1）一份基于证据的识别表，包含13个风险因素，以识别有退出风险的患者（称为优先患者）；2）一项针对这些患者的附加干预措施，包括三个核心要素——指定一名联系人、系统沟通和随访。在为期六个月的可行性阶段，纳入了260名患者。其中，91名（35%）被确定为优先患者。心脏康复团队发现该计划相关、易于融入日常工作流程且适用于实践。患者咨询对附加干预措施的三个核心要素给出了积极反馈。
本文概述了“心脏优先计划”的制定和可行性测试，该计划是为识别和支持优先患者而共同制定的。该计划通过三阶段迭代共同制定过程开发，被发现与社区医疗服务相关且易于实施。心脏康复团队重视其支持优先患者的结构化方法，患者也认为它符合他们的需求。尽管初步结果很有希望，但需要进一步研究来评估该计划的有效性和广泛实施的适用性。
ClinicalTrials.gov NCT06575764，于2024年8月28日追溯注册。
