Eficacia de un Programa Multidisciplinar de Gestión de Cuidados en Pacientes que Ingresan por Insuficiencia Cardiaca (ProMIC)

Abstract

Objetivo: Evaluar la eficacia de « ProMIC » , programa multidisciplinar de atención a pacientes con insuficiencia cardiaca (IC), para reducir de la tasa de reingresos por IC. Dise ̃ no: Ensayo cuasiexperimental multicéntrico con grupo control. Emplazamiento: Doce centros de salud y 3 hospitales del País Vasco. Participantes: Pacientes mayores de 40 a ̃ nos ingresados por IC en situación funcional ii-iv de la New York Heart Association. Intervenciones: En los pacientes ProMIC se realizó una intervención clínica estructurada basada en las guías de práctica clínica y en el modelo de atención a la cronicidad. Los pacientes control recibieron cuidados habituales. Mediciones principales: Tasa de reingresos por IC y calidad de vida relacionada con la salud.

Objective: To assess the efficacy of the ProMIC, multidisciplinary program for patients admitted at hospital because of heart failure (HF) programme, in reducing the HF-related readmission rate.

Desing: Quasi-experimental research with control group.

Settings: Twelve primary health care centres and 3 hospitals from the Basque Country.

Participants: Aged 40 years old or above patients admitted for HF with a New York Heart Association functional class II to IV.

Interventions: Patients in the intervention group carried out the ProMIC programme, a structured clinical intervention based on clinical guidelines and on the chronic care model. Control group received usual care.

Main measurements: The rate of readmission for HF and health-related quality of life Results: One hundred fifty five patients were included in ProMIC group and 129 in control group. 45 rehospitalisation due to heart failure happened in ProMIC versus 75 in control group (adjusted hazard ratio=0.59, CI 95%:0.36-0.98; P=.049). There were significant differences in specific quality of Life al 6 months. No significant differences were found in rehospitalisation due to all causes, due to cardiovascular causes, visits to emergency room, mortality, the combined variable of these events, the functional capacity or quality of life at 12 months of follow up.

Conclusions: ProMIC reduces significantly heart failure rehospitalisation and improve quality of life al 6 months of follow up. No significant differences were found in the rests of variables (C) 2018 The Authors. Published by Elsevier Espana, S.L.U.