ItzuliEficacia de un Programa Multidisciplinar de Gestión de Cuidados en Pacientes que Ingresan por Insuficiencia Cardiaca (ProMIC)
Atención Primaria 51(3) : 142-152 (2019)
Laburpena
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.
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