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  • Markgren, Rickard (author)

Impacts of person-centred integrated chronic heart failure and palliative home care on pharmacological heart failure treatment : a substudy of a randomised trial

  • Article/chapterEnglish2019

Publisher, publication year, extent ...

  • 2016-01-20
  • London :BMJ Publishing Group Ltd,2019
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:umu-115214
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-115214URI
  • https://doi.org/10.1136/bmjspcare-2015-000894DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • OBJECTIVE: Patients with chronic heart failure (CHF) may be insufficiently treated pharmacologically. Recently, we presented a person-centred integrated Palliative advanced homecaRE and heart FailurE caRe (PREFER) strategy and compared it with usual care (control). Patients managed according to PREFER had improved health-related quality of life and markedly reduced hospitalisations compared with the control group. We hypothesised that these improvements may have been partly due to better drug treatments within the PREFER strategy. Thus, our aim in this study was to explore the management of drug treatments in the PREFER group compared with the control group.METHODS: Doses and numbers of drugs and the number of patients receiving the target doses based on current guidelines were measured and compared between the groups at the start and finish of the study.RESULTS: The percentages of ACE inhibitors (ACEIs) or mineralocorticoid receptor antagonists (MRAs) increased, while loop diuretics decreased in the PREFER arm during the study, although the differences were not significant. Beta-receptor blockers (BBs) decreased somewhat in both groups. The number of patients treated with MRAs differed the most between groups, and increased from 10 (28%) to 15 (48%) in the PREFER arm compared with 13 (35%) vs 13 (39%) in the control group. The change in patients receiving full target doses (+8 vs. +1) of the ACEIs/angiotensin receptor blockers, BBs and MRAs were significantly higher (p=0009) in the PREFER arm than in the control arm.CONCLUSIONS: Person-centred integrated care of patients with severe CHF was associated with increased evidence-based drug treatments, especially MRAs.CLINICAL TRIAL NUMBER: NCT01304381.

Subject headings and genre

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  • Brännström, MargaretaUmeå universitet,Institutionen för omvårdnad,Strategic Research Program in Health Care Sciences (SFO-V), “Bridging Research and Practice for Better Health”(Swepub:umu)mabr0002 (author)
  • Lundgren, Claes (author)
  • Boman, KurtUmeå universitet,Avdelningen för medicin,Skellefteå Research Unit(Swepub:umu)kubo0001 (author)
  • Umeå universitetInstitutionen för omvårdnad (creator_code:org_t)

Related titles

  • In:BMJ Supportive & Palliative CareLondon : BMJ Publishing Group Ltd9:12045-435X2045-4368

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Markgren, Rickar ...
Brännström, Marg ...
Lundgren, Claes
Boman, Kurt
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MEDICAL AND HEALTH SCIENCES
MEDICAL AND HEAL ...
and Health Sciences
and Nursing
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BMJ Supportive & ...
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Umeå University

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