Impact of a comprehensive telephone-based disease management programme on quality-of-life in patients with heart failure.

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dc.contributor.authorRamachandran, Ken_US
dc.contributor.authorHusain, Nen_US
dc.contributor.authorMaikhuri, Ren_US
dc.contributor.authorSeth, Sen_US
dc.contributor.authorVij, Aen_US
dc.contributor.authorKumar, Men_US
dc.contributor.authorSrivastava, Nen_US
dc.contributor.authorPrabhakaran, Den_US
dc.contributor.authorAiran, Ben_US
dc.contributor.authorReddy, K Srinathen_US
dc.date.accessioned2007-03-07en_US
dc.date.accessioned2009-06-03T05:31:28Z
dc.date.available2007-03-07en_US
dc.date.available2009-06-03T05:31:28Z
dc.date.issued2007-03-07en_US
dc.description.abstractBACKGROUND: Disease management programmes for patients with heart failure have improving the quality-of-life (QOL) of patients with heart failure. METHODS: Patients attending the heart failure clinic were randomized into 2 groups of 25 patients each. The control group was managed in the heart failure clinic and the intervention group underwent the following additional interventions: (i) interactive sessions with the patient and spouse informing them about the disease, drugs, and self-management of fluid intake and diuretic dose; (ii) a telephonic helpline was established and regular telephone calls made to reinforce the information and modify drug dosages. The QOL was assessed using the Kansas City Cardiomyopathy questionnaire. Functional capacity was assessed by the 6-minute walk test. Continuous variables were compared with the Student t-test (paired or unpaired). RESULTS: There was significant improvement in the QOL and functional capacity of patients in the intervention group compared with controls over a 6-month period. The mean (SD) QOL scores in the intervention group improved from 60.0 (23.6) to 76.3 (17.3) but did not change significantly in the control group (62.2 [22.6] to 63.4 [21.9]). There was a similar improvement in the functional capacity measured by the 6-minute walk test in the intervention group (from 202.2 [81.5] to 238.1 [100.9] metres, p < 0.05) but not in the control group (193.8 [81.5] to 179.7 [112.0] metres). In the intervention group, the use of beta-blockers and angiotensin-converting enzyme inhibitors was similar but in the intervention group patients were placed on higher doses. There was no significant difference in the number of emergency room visits or admissions in either group. For every 20 patients in the intervention group, 14 patients improved by 1 functional class while in the control group this was observed in only 3 patients for every 20 treated. CONCLUSION: This study demonstrates that in the setting of a developing country, improvement in QOL by intensive management of heart failure patients through a heart failure programme with telephonic reinforcement and a helpline is greater than that usually achieved with drug therapy in a routine heart failure clinic.en_US
dc.description.affiliationDepartment of Cardiology, All India Institute of Medical Sciences, New Delhi 110029, India.en_US
dc.identifier.citationRamachandran K, Husain N, Maikhuri R, Seth S, Vij A, Kumar M, Srivastava N, Prabhakaran D, Airan B, Reddy KS. Impact of a comprehensive telephone-based disease management programme on quality-of-life in patients with heart failure. National Medical Journal of India. 2007 Mar-Apr; 20(2): 67-73en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/118427
dc.language.isoengen_US
dc.source.urihttps://www.nmji.inen_US
dc.subject.meshAdrenergic beta-Antagonists --therapeutic useen_US
dc.subject.meshAdulten_US
dc.subject.meshAngiotensin-Converting Enzyme Inhibitors --therapeutic useen_US
dc.subject.meshComprehensive Health Careen_US
dc.subject.meshCounselingen_US
dc.subject.meshDisease Managementen_US
dc.subject.meshFemaleen_US
dc.subject.meshHeart Failure --drug therapyen_US
dc.subject.meshHotlinesen_US
dc.subject.meshHumansen_US
dc.subject.meshIndiaen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshOutcome and Process Assessment (Health Care)en_US
dc.subject.meshPatient Education as Topicen_US
dc.subject.meshProgram Evaluationen_US
dc.subject.meshQuality of Life --psychologyen_US
dc.subject.meshQuestionnairesen_US
dc.titleImpact of a comprehensive telephone-based disease management programme on quality-of-life in patients with heart failure.en_US
dc.typeJournal Articleen_US
dc.typeRandomized Controlled Trialen_US
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