Exploring the potential to remain "young @ Heart": Initial findings of a multi-centre, randomised study of nurse-led, home-based intervention in a hybrid health care system

Yih Kai Chan, Simon Stewart, Alicia Calderone, Paul Scuffham, Stan Goldstein, Melinda J. Carrington

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Disease management programs have been shown to improve health outcomes in high risk individuals in many but not all health care systems. Methods: Young @ Heart is a multi-centre, randomised controlled study of a nurse-led, home-based intervention (HBI) program vs. usual care (UC) in privately insured patients in Australia aged ≥ 45 years following an acute cardiac admission. Intensity of HBI is tailored to an individual's clinical stability, management and risk profile. The primary endpoint is the rate of all-cause stay during a mean of 2.5 years follow-up. Results: A target of 602 adults (72% men) were randomised to HBI (n = 306) or UC (n = 296); their initial profiles being well matched. At baseline, 71% were overweight (body mass index 29.7 ± 3.9 kg/m 2) and 66% had an elevated blood pressure (153 ± 18/89 ± 7 mm Hg). Over half had a history of smoking and 39% had a sub-optimal total cholesterol level > 4 mmol/L. Overall, 62% (376 cases) were treated for coronary artery disease (27% with multi-vessel disease and 39% underwent cardiac revascularisation). A further 20% (120 cases) were treated for a cardiac arrhythmia (predominantly atrial fibrillation) and 19% type 2 diabetes mellitus. At 7-14 days post-discharge, 293 (96%) HBI patients received a home visit triggering urgent clinical review and/or enhanced clinical management in many patients. Conclusions: The Young @ Heart intervention is a well accepted and potentially effective intervention to reduce recurrent hospital stay in privately insured cardiac patients in Australia.

Original languageEnglish
Pages (from-to)52-58
Number of pages7
JournalInternational Journal of Cardiology
Volume154
Issue number1
DOIs
Publication statusPublished - 12 Jan 2012
Externally publishedYes

Keywords

  • Cardiovascular disease
  • Chronic heart disease
  • Disease management
  • Prevention

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