Programa de atención especializada en la insuficiencia cardíaca terminal. Experiencia piloto de una unidad de insuficiencia cardíaca

Roig, Eulàlia; Pérez‐Villa, Félix; Cuppoletti, Alfredo; Castillo, Magdalena López; Hernández, Nuria; Morales, Manel; Betriu, Amadeo

doi:10.1157/13084637

Cited by 23 publications

(11 citation statements)

References 34 publications

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“…We determined 2 studies to have incomplete outcome data in their control groups as one had a 20.6% dropout rate [ 25 ] and the other had 17% who withdrew consent [ 26 ], creating an imbalance between the intervention and control groups. Three studies involved possible lack of protocol standardization [ 24 , 25 , 27 ]. Overall, the RCTs were modest in quality, at best.…”

Section: Resultsmentioning

confidence: 99%

“…Three observational studies, including one that tested the efficacy of a day hospital scheme, reported average readmissions per patient [ 23 , 24 , 27 ] ( Fig 3 ). All 3 studies reported a significant reduction in favor of substitutive hospital care (MD range, -3.80 to -0.70 readmissions per patient).…”

Section: Resultsmentioning

confidence: 99%

“…Two observational studies reported the length of stay in index care [ 24 , 27 ]. One showed a significantly longer length of stay in the HaH group as compared with the concurrent control group (mean [SD] of 12.8 [6.53] days versus 9.4 [7.4] days, respectively; P<0.05), while the other reported a significant reduction in the length of index stay in the day hospital group (MD, 34 days [95% CI, 45 to 22]; P < 0.001).…”

Section: Resultsmentioning

confidence: 99%

“…One RCT and one observational study measured the total number of readmissions [ 25 , 27 ]. We did not pool the results due to differences in design and outcome measurements.…”

Section: Resultsmentioning

confidence: 99%

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Efficacy of Hospital at Home in Patients with Heart Failure: A Systematic Review and Meta-Analysis

et al. 2015

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BackgroundHeart failure (HF) is the commonest cause of hospitalization in older adults. Compared to routine hospitalization (RH), hospital at home (HaH)—substitutive hospital-level care in the patient’s home—improves outcomes and reduces costs in patients with general medical conditions. The efficacy of HaH in HF is unknown.Methods and ResultsWe searched MEDLINE, Embase, CINAHL, and CENTRAL, for publications from January 1990 to October 2014. We included prospective studies comparing substitutive models of hospitalization to RH in HF. At least 2 reviewers independently selected studies, abstracted data, and assessed quality. We meta-analyzed results from 3 RCTs (n = 203) and narratively synthesized results from 3 observational studies (n = 329). Study quality was modest. In RCTs, HaH increased time to first readmission (mean difference (MD) 14.13 days [95% CI 10.36 to 17.91]), and improved health-related quality of life (HrQOL) at both, 6 months (standardized MD (SMD) -0.31 [-0.45 to -0.18]) and 12 months (SMD -0.17 [-0.31 to -0.02]). In RCTs, HaH demonstrated a trend to decreased readmissions (risk ratio (RR) 0.68 [0.42 to 1.09]), and had no effect on all-cause mortality (RR 0.94 [0.67 to 1.32]). HaH decreased costs of index hospitalization in all RCTs. HaH reduced readmissions and emergency department visits per patient in all 3 observational studies.ConclusionsIn the context of a limited number of modest-quality studies, HaH appears to increase time to readmission, reduce index costs, and improve HrQOL among patients requiring hospital-level care for HF. Larger RCTs are necessary to assess the effect of HaH on readmissions, mortality, and long-term costs.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…One RCT and one observational study measured the total number of readmissions [ 25 , 27 ]. We did not pool the results due to differences in design and outcome measurements.…”

Section: Resultsmentioning

confidence: 99%

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Efficacy of Hospital at Home in Patients with Heart Failure: A Systematic Review and Meta-Analysis

et al. 2015

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“…Como problemas en el estudio se plantean situaciones tales como la necesidad de interacción entre el personal de salud y la familia en la orientación y acompañamiento para el final de la vida de la persona que padece la enfermedad (2-4); la sobrecarga de trabajo para el cuidador del paciente (5)(6); la enfermedad cardiovascular como problema de salud en el mundo y en Colombia; las personas con enfermedad cardiovascular en fase terminal de la enfermedad, como grupo infratratado en comparación con las personas que padecen enfermedad oncológica (7)(8)(9); y finalmente los vacíos en la investigación en enfermería, a pesar de que existen estudios en la disciplina con relación a cuidados paliativos o el buen morir en el paciente con enfermedad cardiovascular; los existentes en su mayoría lo muestran como un fenómeno cuantitativo, todavía externo a las personas (10)(11)(12)(13)(14).…”

Section: Introductionunclassified

Necesidad De Prácticas Cuidantes Culturalmente Congruentes: Personas Con Enfermedad Cardiovascular Al Final De La Vida

Cardona

Herrera²

2017

ECH

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El objetivo del estudio fue conocer las prácticas de cuidado que identifican los cuidadores familiares de personas con enfermedad cardiovascular al final de la vida. Se realizó una investigación cualitativa, que utilizó el método etnográfico particularista, en Medellín, Colombia, entre septiembre de 2014 y junio de 2015. Las participantes fueron mujeres cuidadoras familiares de personas con enfermedad cardiovascular en la etapa final de la vida. El estudio fue efectuado en tres escenarios de cuidado: domicilios, instituciones hospitalarias y centro geriátrico con unidad de cuidados paliativos. Con base en el análisis de los datos, emergió la categoría "Prácticas de Cuidado", que contiene cuatro subcategorías: a) Estar pendientes: insistir al paciente, brindar cuidados respiratorios, alimentarios, de hidratación, temperatura corporal, eliminación urinaria y fecal, movilidad y postura, cuidados de la piel, higiene y estéticos; b) Mitigar el dolor y el sufrimiento; c) Cuidados espirituales; y d) Cuidados paliativos. Del estudio se concluye que unas buenas prácticas cuidantes exigen conocimientos específicos por parte de las cuidadoras familiares, de las personas con enfermedad cardiovascular en la etapa final de la vida, así como de la patología misma. Además, se requiere un abordaje desde la multidimensionalidad humana para tomar decisiones acertadas y respetuosas culturalmente, con cuidados orientados al binomio (paciente-cuidador familiar).

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End-of-Life Care in Hospitalized Patients with Cardiovascular and Cerebrovascular Disease

Díez‐Villanueva

Martínez‐Sellés

2014

End-of-Life Care in Cardiovascular Disease

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Programa de atención especializada en la insuficiencia cardíaca terminal. Experiencia piloto de una unidad de insuficiencia cardíaca

Cited by 23 publications

References 34 publications

Efficacy of Hospital at Home in Patients with Heart Failure: A Systematic Review and Meta-Analysis

Efficacy of Hospital at Home in Patients with Heart Failure: A Systematic Review and Meta-Analysis

Necesidad De Prácticas Cuidantes Culturalmente Congruentes: Personas Con Enfermedad Cardiovascular Al Final De La Vida

End-of-Life Care in Hospitalized Patients with Cardiovascular and Cerebrovascular Disease

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