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Title: Planning to reduce 30-day adverse events after discharge of frail elderly patients with acute heart failure: design and rationale for the DEED FRAIL-AHF trial
Author: Martín-Sánchez, Francisco Javier
Llopis García, Guillermo
Llorens, Pere
Jacob, Javier
Herrero, Pablo
Gil, Víctor
Juan i Pastor, Antoni
López-Picado, Amanda
Fuentes Ferrer, Manuel
Rosselló, Xavier
Gil, Pedro
Díez Villanueva, Pablo
Calvo, Elpidio
Mendez Bailon, Manuel
Cuesta-Triana, Federico
González Armengol, Juan Jorge
González del Castillo, Juan
Runtkle, Isabelle
Vidán, Ma. Teresa
Comín Colet, Josep
Cruz Jentoft, Alfonso J.
Bueno, Héctor
Miró i Andreu, Òscar
Fernández Pérez, Cristina
Keywords: Insuficiència cardíaca
Urgències cardiovasculars
Persones grans
Ingressos i altes en els hospitals
Heart failure
Cardiovascular emergencies
Older people
Hospital admission and discharge
Issue Date: 1-Feb-2019
Publisher: Saned
Abstract: Objectives: To demonstrate the efficacy of a system for comprehensive care transfer (Multilevel Guided Discharge Plan [MGDP]) for frail older patients diagnosed with acute heart failure (AHF) and to validate the results of MGDP implementation under real clinical conditions. The MGDP seeks to reduce the number of adverse outcomes within 30 days of emergency department (ED) discharge. Material and methods: We will enroll frail patients over the age of 70 years discharged home from the ED with a main diagnosis of AHF. The MGDP includes the following components: 1) a checklist of clinical recommendations and resource activations, 2) scheduling of an early follow-up visit, 3) transfer of information to the primary care doctor, and 4) written instructions for the patient. Phase 1 of the study will be a matched-pair cluster-randomized controlled trial. Ten EDs will be randomly assigned to the intervention group and 10 to the control group. Each group will enroll 480 patients, and the outcomes will be compared between groups. Phase 2 will be a quasi-experimental study of the intervention in 300 new patients enrolled by the same 20 EDs. The outcomes will be compared to those for each Phase-1 group. The main endpoint at 30 days will be a composite of 2 outcomes: revisits to an ED and/for hospitalization for AHF or cardiovascular death. Conclusion: The study will assess the efficacy and feasibility of comprehensive MGDP transfer of care for frail older AHF patients discharged home.
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It is part of: Emergencias, 2019, vol. 31, num. 1, p. 27-35
ISSN: 1137-6821
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (Ciències Clíniques)

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