Appendix A Technology Assessment: Non-Pharmacological Interventions for Post-DiscTechnology assessment on the effectiveness of non-pharmacological interventions for post-discharge care in heart failure patients. Table of ContentsAppendix ASearch strategy#Search HistoryResults1 discharge planning.mp. or exp Patient Discharge/326322 case management.mp. or exp Patient Care Planning/ or exp Case Management/922383 patient readmission.mp.92664 Aftercare/125685 Continuity of Patient Care/202176 Patient Transfer/80947 Post discharg$.tw.21808 Postdischarg$.tw.27389 Post hospital$.tw.106110 Posthospital$.tw.104711Predischarg$.tw.181012 Pre discharg$.tw.49613 Patient$ discharg$.tw.703914Discharg$.ti.2427015 ((readmission$ or early or premature or care or medication or destination or decision or decid$ or support$ or prepar$ or process$ or plan$ or system$) adj6 discharg$).tw.2556416 or/1-1519413317 exp Heart Failure, Congestive/ or exp Cardiac Output, Low/ or Heart failure.mp.16791318 16 and 17366019 limit 18 to english language339420 limit 19 to “all adult (19 plus years)”254421 randomized controlled trial.pt.68870622 controlled clinical trial.pt.22147923 Randomized controlled trials/12596424 random allocation/11219225 double-blind method/25290226 single-blind method/2740927 clinical trial.pt.15731928 (random$ or rct).tw.90034729 controlled clinical trials/3915730 (clin$ adj trial$).tw.22283931 ((singl$ or doubl$ or trebl$ or Tripl$) adj (blind$ or mask$)).tw.27558032 exp PLACEBOS/7014333 placebo$.tw.28874334 cross-over studies/5331835 evaluation studies/21425236 or/21-35204805737 20 and 3668438 animal/ not (animal/ and human/)307877739 37 not 3868440 limit 39 to comment and (letter or editorial).pt.141 limit 39 to (addresses or bibliography or biography or case reports or congresses or consensus development conference or consensus development conference, nih or dictionary or directory or editorial or festschrift or government publications or interview or lectures or legal cases or legislation or news or newspaper article or patient education handout or periodical index)942 39 not (40 or 41)67443 limit 42 to (guideline or meta analysis or practice guideline or “review”)3044 42 not4364445 limit 44 to yr=1990-200761546 remove duplicates from 45273 Discharge Plan data extraction/summary tablesStudy Year UI number Methods Study design description Randomization method Allocation concealment Blinding Number of centers Recruitment years Duration of followup Participants Country Study inclusion criteria Study exclusion criteria OverallInterventionControls N randomized Mean age (SD) y Males % Race / Ethnicity % Severity of heart failure (at index admission) NYHA: LVEF%:NYHA: LVEF%: Severity of heart failure (at baseline) NYHA: LVEF%:NYHA: LVEF%: Duration of CHF History - Myocardial infarction History of other CVD disease ACE inhibitor use B-blockers Diuretics Other medications Interventions Duration of intervention Intervention group name Description of intervention During index hospitalization After discharge Description of comparator Followup times Statistical Analyses Intention to treat Adjusted analyses Outcomes description Primary endpoint (with definition) Secondary endpoint (with definition) Notes Rationale for sample size Reasons for exclusion List biases Funding source Is there any difference between groups at baseline Discharge Plan data extraction/summary tablesAPPLICABILITYQUALITY Wide Applicability:sample representative of Medicare population in relevant setting. Patient’s age (older adult), gender, spectrum of disease severity and type, etc are representative of population of interest. A Good quality:Prospective, no obvious biases or reporting errors, <20% dropout, complete reporting of data. Moderate Applicability:sample is an important sub-group of population of interest. Possibly limited to a narrow or young age range, type of disease, gender etc. B Fair quality:Problems with study/paper unlikely to cause major bias.. Narrow Applicability:sample represents only a narrow, atypical subgroup of population of interest, or old study. C Poor quality:Cannot exclude possible significant biases. Poor methods, incomplete data, reporting errors.If applicability is graded narrow or moderate, what are the limiting factors?If Quality is rated B or C, what are the limiting factors? (i.e., incomplete data, errors in analysis, definitions not clear, poor follow-up, dropouts) Summary table templatesRandomized Controlled Studies (Intervention vs. Control), For event ratesPopulation recruited:OutcomeStudy, Year CountryFollowup Duration (Intervention y)No. AnalyzedControl UsedSeverity of CHFIntervention componentsEvent RateNet changeP withinP BetweenQualityIntervControlIntervControl Randomized Controlled Studies (Intervention vs. Control), For continuous measures or that provide odds/risk ratioPopulation recruited:OutcomeStudy, Year CountryFollowup Duration (Intervention y)No. AnalyzedControl UsedSeverity of CHFIntervention componentsBaselineResults/FinalQualityIntervControlMetric/ UnitsIntervControlP Between Text results: BibliographyAtienza F.Multicenter randomized trial of a comprehensive hospital discharge and outpatient heart failure management program. European Journal of Heart Failure: Journal of the Working Group on Heart Failure of the European Society of Cardiology 2004 Aug;(5):643-52. AN - CN-00490661Barth V.A nurse-managed discharge program for congestive heart failure patients: outcomes and costs. Home Health Care Management & Practice 2001;13(6):436-43.Benatar D, Bondmass M, Ghitelman J, et al.Outcomes of chronic heart failure.[see comment]. Archives of Internal Medicine 2003 Feb 10;163(3):347-52. UI - 12578516Blue L, Lang E, McMurray JJV, et al.Randomized controlled trial of specialist nurse intervention in heart failure. BMJ 2001 Sep 29; 323(7315): 715-8 (10 ref) ;(7315):715-8. UI - 2002021276Bouvy ML, Heerdink ER, Urquhart J, et al.Effect of a pharmacist-led intervention on diuretic compliance in heart failure patients: a randomized controlled study.[erratum appears in J Card Fail. 2003 Dec;9(6):481 Note: Hoe Arno W [corrected to Hoes Arno W]]. Journal of Cardiac Failure 2003 Oct;9(5):404-11. UI - 14583903Capomolla S P.Heart failure case disease management program: a pilot study of home telemonitoring versus usual care. European Heart Journal Supplements 2004;(6):F91-F98. AN - CN-00516857Capomolla S, Febo O, Ceresa M, et al.Cost/utility ratio in chronic heart failure: comparison between heart failure management program delivered by day-hospital and usual care.[see comment]. Journal of the American College of Cardiology 2002 Oct 2;40(7):1259-66. UI - 12383573Cleland JG, Louis AA, Rigby AS, et al.Noninvasive home telemonitoring for patients with heart failure at high risk of recurrent admission and death: the Trans-European Network-Home-Care Management System (TEN-HMS) study.[see comment]. Journal of the American College of Cardiology 2005 May 17;45(10):1654-64. UI - 15893183Cline CM, Israelsson BY, Willenheimer RB, et al.Cost effective management programme for heart failure reduces hospitalisation.[see comment]. Heart 1998 Nov;80(5):442-6. UI - 9930041DeBusk RF, Miller NH, Parker KM, et al.Care management for low-risk patients with heart failure: a randomized, controlled trial.[see comment][summary for patients in Ann Intern Med. 2004 Oct 19;141(8):I58; PMID: 15492334]. Annals of Internal Medicine 2004 Oct 19;141(8):606-13. UI - 15492340Del SD, Pulignano G, Minardi G, et al.Two-year outcome of a prospective, controlled study of a disease management programme for elderly patients with heart failure.[see comment]. Journal of Cardiovascular Medicine 2007 May;8(5):324-9. UI - 17443097Doughty RN, Wright SP, Pearl A, et al.Randomized, controlled trial of integrated heart failure management: The Auckland Heart Failure Management Study.[see comment]. European Heart Journal 2002 Jan;23(2):139-46. UI - 11785996Ducharme A, Doyon O, White M, et al.Impact of care at a multidisciplinary congestive heart failure clinic: a randomized trial.[see comment]. CMAJ Canadian Medical Association Journal 2005 Jul 5;173(1):40-5. UI - 15997043Dunagan WC, Littenberg B, Ewald GA, et al.Randomized trial of a nurse-administered, telephone-based disease management program for patients with heart failure.[see comment]. Journal of Cardiac Failure 2005 Jun;11(5):358-65. UI - 15948086Ekman I, Andersson B, Ehnfors M, et al.Feasibility of a nurse-monitored, outpatient-care programme for elderly patients with moderate-to-severe, chronic heart failure.[see comment]. European Heart Journal 1998 Aug;19(8):1254-60. UI - 9740348Gattis WA, Hasselblad V, Whellan DJ, et al.Reduction in heart failure events by the addition of a clinical pharmacist to the heart failure management team: results of the Pharmacist in Heart Failure Assessment Recommendation and Monitoring (PHARM) Study.[see comment]. Archives of Internal Medicine 1999 Sep 13;159(16):1939-45. UI - 10493325GESICA I.Randomised trial of telephone intervention in chronic heart failure: DIAL trial.[see comment]. BMJ 2005 Aug 20;331(7514):425. UI - 16061499Goldberg LR, Piette JD, Walsh MN, et al.Randomized trial of a daily electronic home monitoring system in patients with advanced heart failure: the Weight Monitoring in Heart Failure (WHARF) trial. American Heart Journal 2003 Oct;146(4):705-12. UI - 14564327Harrison MB, Browne GB, Roberts J, et al.Quality of life of individuals with heart failure: a randomized trial of the effectiveness of two models of hospital-to-home transition.[see comment]. Medical Care 2002 Apr;40(4):271-82. UI - 12021683Holland R, Brooksby I, Lenaghan E, et al.Effectiveness of visits from community pharmacists for patients with heart failure: HeartMed randomised controlled trial.[see comment]. BMJ 2007 May 26;334(7603):1098. UI - 17452390Jaarsma T, Halfens R, Tan F, et al.Self-care and quality of life in patients with advanced heart failure: the effect of a supportive educational intervention. Heart & Lung 2000 Sep;29(5):319-30. UI - 10986526Jerant AF, Azari R, Nesbitt TS.Reducing the cost of frequent hospital admissions for congestive heart failure: a randomized trial of a home telecare intervention. Medical Care 2001 Nov;39(11):1234-45. UI - 11606877Kasper EK, Gerstenblith G, Hefter G, et al.A randomized trial of the efficacy of multidisciplinary care in heart failure outpatients at high risk of hospital readmission. Journal of the American College of Cardiology 2002 Feb 6;39(3):471-80. UI - 11823086Koelling TM, Johnson ML, Cody RJ, et al.Discharge education improves clinical outcomes in patients with chronic heart failure. Circulation 2005 Jan 18;111(2):179-85. UI - 15642765Krumholz HM, Amatruda J, Smith GL, et al.Randomized trial of an education and support intervention to prevent readmission of patients with heart failure.[see comment]. Journal of the American College of Cardiology 2002 Jan 2;39(1):83-9. UI – 11755291Laramee AS, Levinsky SK, Sargent J, et al.Case management in a heterogeneous congestive heart failure population: a randomized controlled trial. Archives of Internal Medicine 2003 Apr 14;163(7):809-17. UI - 12695272Ledwidge M, Ryan E, O'Loughlin C, et al.Heart failure care in a hospital unit: a comparison of standard 3-month and extended 6-month programs. European Journal of Heart Failure 2005 Mar 16;7(3):385-91. UI - 15718179Linne AB, Liedholm H.Effects of an interactive CD-program on 6 months readmission rate in patients with heart failure - a randomised, controlled trial [NCT00311194]. BMC Cardiovascular Disorders 2006;6:30. UI - 16796760Lopez CC, Falces SC, Cubi QD, et al.Randomized clinical trial of a postdischarge pharmaceutical care program vs regular follow-up in patients with heart failure.[see comment]. Farmacia Hospitalaria 2006 Nov;30(6):328-42. UI - 17298190McDonald K, Ledwidge M, Cahill J, et al.Heart failure management: multidisciplinary care has intrinsic benefit above the optimization of medical care. Journal of Cardiac Failure 2002 Jun;8(3):142-8. UI - 12140806Mejhert M, Kahan T, Persson H, et al.Limited long term effects of a management programme for heart failure.[see comment]. Heart 2004 Sep;90(9):1010-5. UI - 15310688Morcillo C.[Evaluation of a home-based intervention in heart failure patients. Results of a randomized study]. Revista espanola de cardiologia 2005 Jun;(6):618-25. AN - CN-00528602Murray MD, Young J, Hoke S, et al.Pharmacist intervention to improve medication adherence in heart failure: a randomized trial. Annals of Internal Medicine 2007 May 15;146(10):714-25. UI - 17502632Naylor MD, Brooten DA, Campbell RL, et al.Transitional care of older adults hospitalized with heart failure: a randomized, controlled trial.[see comment][erratum appears in J Am Geriatr Soc. 2004 Jul;52(7):1228]. Journal of the American Geriatrics Society 2004 May;52(5):675-84. UI - 15086645Nucifora G, Albanese MC, De BP, et al.Lack of improvement of clinical outcomes by a low-cost, hospital-based heart failure management programme. Journal of Cardiovascular Medicine 2006 Aug;7(8):614-22. UI - 16858241Rainville EC.Impact of pharmacist interventions on hospital readmissions for heart failure. American Journal of Health-System Pharmacy 1999 Jul 1;56(13):1339-42. UI – 10683133Rich MW, Beckham V, Wittenberg C, et al.A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure.[see comment]. New England Journal of Medicine 1995 Nov 2;333(18):1190-5. UI - 7565975Rich MW, Vinson JM, Sperry JC, et al.Prevention of readmission in elderly patients with congestive heart failure: results of a prospective, randomized pilot study. Journal of General Internal Medicine 1993 Nov;8(11):585-90. UI - 8289096Riegel B, Carlson B, Glaser D, et al.Randomized controlled trial of telephone case management in Hispanics of Mexican origin with heart failure.[see comment]. Journal of Cardiac Failure 2006 Apr;12(3):211-9. UI - 16624687Riegel B, Carlson B, Kopp Z, et al.Effect of a standardized nurse case-management telephone intervention on resource use in patients with chronic heart failure.[see comment]. Archives of Internal Medicine 2002 Mar 25;162(6):705-12. UI - 11911726Sethares KA, Elliott K.The effect of a tailored message intervention on heart failure readmission rates, quality of life, and benefit and barrier beliefs in persons with heart failure. Heart & Lung 2004 Jul;33(4):249-60. UI - 15252415Sisk JE, Hebert PL, Horowitz CR, et al.Improving patient care. Effects of nurse management on the quality of heart failure care in minority communities: a randomized trial. Annals of Internal Medicine 2006 Aug 15; 145(4): 273-83, I-28 (40 ref) ;(4):273-83. UI - 2009269286Stewart S, Marley JE, Horowitz JD.Effects of a multidisciplinary, home-based intervention on unplanned readmissions and survival among patients with chronic congestive heart failure: a randomised controlled study. Lancet 1999 Sep 25;354(9184):1077-83. UI - 10509499Stewart S, Pearson S, Horowitz JD.Effects of a home-based intervention among patients with congestive heart failure discharged from acute hospital care. Archives of Internal Medicine 1998 May 25;158(10):1067-72. UI - 9605777Stromberg A, Martensson J, Fridlund B, et al.Nurse-led heart failure clinics improve survival and self-care behaviour in patients with heart failure: results from a prospective, randomised trial.[see comment]. European Heart Journal 2003 Jun;24(11):1014-23. UI - 12788301Thompson DR, Roebuck A, Stewart S.Effects of a nurse-led, clinic and home-based intervention on recurrent hospital use in chronic heart failure.[see comment]. European Journal of Heart Failure 2005 Mar 16;7(3):377-84. UI - 15718178Tsuyuki RT, Fradette M, Johnson JA, et al.A multicenter disease management program for hospitalized patients with heart failure.[see comment]. Journal of Cardiac Failure 2004 Dec;10(6):473-80. UI - 15599837Varma S, McElnay JC, Hughes CM, et al.Pharmaceutical care of patients with congestive heart failure: interventions and outcomes. Pharmacotherapy 1999 Jul;19(7):860-9. UI - 10417035Wierzchowiecki M, Poprawski K, Nowicka A, et al.A new programme of multidisciplinary care for patients with heart failure in Pozna: one-year follow-up. Kardiologia Polska 1071 Feb;64(10):1063-70. UI - 17089238Proceed to Appendix B Return to Table of Contents Current as of February 2009 Internet Citation: Appendix A: Technology Assessment: Non-Pharmacological Interventions for Post-Disc. February 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/ta/heart-failure-discharge-care/appendix-a.html
Back
