Multidisciplinary intensive education in the hospital improves outcomes for hospitalized heart failure patients in a Japanese rural setting

BMC Health Services Research

Kazuhiro Yamamoto¹  Masayuki Hirai¹  Kensaku Yamada¹  Kiyotaka Yanagihara¹  Shinobu Sugihara¹  Masahiko Kato¹  Yoshiharu Kinugasa¹ 

[1] Division of Cardiovascular Medicine, Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University, 36-1 Nishicho, 683-8504 Yonago, Japan

关键词: Self-care behavior;    Team education;    Heart failure management program;    Multidisciplinary intervention;   

Others  :  1126688
DOI  :  10.1186/1472-6963-14-351

 received in 2014-04-30, accepted in 2014-08-14,  发布年份 2014

【 摘 要 】

Background

Heart failure (HF) patients living in rural areas have a lack of HF knowledge and poor self-care because of limited medical care access. Multidisciplinary education to improve self-care behavior is indispensable for such patients. The present study evaluated whether intensive inpatient education improved outcomes of hospitalized HF patients in a Japanese rural setting.

Methods

An inpatient HF management program based on multidisciplinary team intervention was applied to hospitalized HF patients in a Japanese rural area. We defined patients treated within the program from May 2009 to April 2011 as the intervention group (n = 144), and those treated with the usual care from May 2006 to April 2009 as the usual care group (n = 133). The composite endpoints of HF hospitalization and all-cause mortality were compared between the two groups.

Results

Compared with patients in the usual care group, those in the intervention group more often received the optimal interventions such as discharge use of β-blockers, cardiac rehabilitation, pre-discharge diagnostic tests, and multidisciplinary intensive education including nurse-led patient education, pharmacist’s medication teaching, and dietitian’s nutritional guidance (all P < 0.05). The incidence of the composite endpoints significantly decreased after introducing the program (P < 0.001). Among a number of interventions, multidisciplinary intensive education was the most effective intervention to improve the primary outcome (P < 0.001).

Conclusions

Multidisciplinary intensive education is a key strategy for helping improve the outcome for Japanese HF patients in a rural setting. Our data may give a positive impact on the improvement of healthcare system in Japan.

【 授权许可】

   
2014 Kinugasa et al.; licensee BioMed Central Ltd.

【 图 表 】

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