Preliminary results of the study MEETinCYCyprus University of Technology’s state funded budget 2008 e 2011 [Startup Fund EX2007 (04)]

Abstract

Background: Even though heart failure (HF) management programmes have been improved and proved their efficient, no such proramme has been offered until recently in Cyprus. Since 2008 MEETinCY research programme is the first one in Cyprus and it is also a nurse-led management programme for HF patients in Cyprus.Purpose: To determine the effect of a structured educational intervention and / or telephone follow-up programme for patients with HF.Methods: The present study is a randomized control trial with various interventions and longitudinal monitoring. As a part of the larger MEETinCY research project, sampling was extracted from the parent sample, which was conducted between April 2014 and June 2014, using the electronic medical records of patients of five government hospitals.Total acute events of HF decompensation including their clinical and demographic characteristics were recorded in 12 and 24 weeks post discharge. Additional information to support the existence or not of decompensation, if needed, was provided by patients and their relatives, through telephone calls. Events were classified as decompensation of pre-existing HF, or decompensation from other causes.Results: A number of 195 Cypriot HF patients, who received educational intervention and / or telephone follow up calls. were recruited. A reduction of instant risk of HF decompensation at 3 months in 51% [HR: 0,49 (95CI:0,27-0,88] (p = 0,001), was found in the group of telephone follow up, compared to control group. There was no difference between groups regarding the occurrence of death [Control n = 1 (1,8%) vs Intervention n = 2 (2,2%) p = 1],the total visits to emergency department (p = 0,52 ), the total readmissions (p = 0,52), and the cumulative events (visits & readmissions) (p = 0,79). No statistically significant difference was found in the mean hospital length of stay [Control 6,17 ± 8,2 vs Intervention 6,54 ± 9,5 (p =0.874)]. Unfortunately, the promising results of the beneficial effect of the intervention in disease-free survival time for the first 3 months after randomization and perspective monitoring, does not appear to be maintained for long.Conclusions: The present study results showed that advanced nurses in HF who apply structured educational programmes combined with telephone follow up, can enhance the outcome of patients with HF.