[Practice-based Home Visit and Telephone Monitoring of Chronic Heart Failure Patients: Rationale, Design and Practical Application of Monitoring Lists in the HICMan Trial]

Z Evid Fortbild Qual Gesundhwes. 2011;105(6):434-45. doi: 10.1016/j.zefq.2010.06.027. Epub 2010 Jul 21.
[Article in German]

Abstract

Background: Patients with chronic heart failure have complex care needs which can be addressed by case management interventions. Monitoring lists for heart failure were developed and tested as part of a trial evaluating primary care-based case management of patients with heart failure (HICMan).

Method: Design and characteristics of the monitoring lists used during the HICMan trial are described in order to evaluate technical feasibility and time expenditure. In a secondary analysis of data from the HICMan trial descriptive statistics were used.

Results: Two checklists were developed on the basis of evidence-based guidelines to regularly monitor heart failure patients by phone and home visits. These checklists contain questions about heart failure symptoms and signs (precursors) of clinical deterioration. Ninety-seven heart failure patients (64 NYHA class I/II, 33 NYHA class III) were monitored for 12 months. Eighteen critical incidents like acute angina pectoris or acute dyspnoea occurred during the study, two of them leading to immediate hospital admissions. Patients with NYHA class III had significantly more potentially clinically relevant incidents than patients with NYHA class I/II. Mean [SD, range] time expenditure for telephone monitoring was 10min [± 5min, 2 to 38min], for home visits 53min [± 13min, 18 to 90min]. Both monitoring lists appeared to be plausible and feasible tools for the primary care-based case management of heart failure patients.

Publication types

  • English Abstract
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Case Management / organization & administration*
  • Checklist / methods*
  • Chronic Disease
  • Evidence-Based Medicine
  • Feasibility Studies
  • Female
  • General Practice
  • Germany
  • Health Services Research
  • Health Status Indicators
  • Heart Failure / classification
  • Heart Failure / diagnosis
  • Heart Failure / therapy*
  • House Calls*
  • Humans
  • Interviews as Topic / methods*
  • Male
  • Middle Aged
  • Practice Guidelines as Topic
  • Time and Motion Studies