2010

Authors

  • Yih-Kai Chan Yih-Kai Chan
  • Simon Stewart Simon Stewart
  • Alicia Calderone Alicia Calderone
  • Paul Scuffham Paul Scuffham
  • Stan Goldstein Stan Goldstein
  • Melinda J. Carrington Melinda J. Carrington

Background Disease magement programs have been shown to improve health outcomes in high risk individuals in many but not all health care systems. Methods Young @ Heart is a multi-centre, randomised controlled study of a nurse-led, home-based intervention (HBI) program vs. usual care (UC) in privately insured patients in Australia aged = 45 years following an acute cardiac admission. Intensity of HBI is tailored to an individual's clinical stability, magement and risk profile. The primary endpoint is the rate of all-cause stay during a mean of 2.5 years follow-up. Results A target of 602 adults (72% men) were randomised to HBI (n = 306) or UC (n = 296); their initial profiles being well matched. At baseline, 71% were overweight (body mass index 29.7 ᠳ.9 kg/m2) and 66% had an elevated blood pressure (153 ᠱ8/89 ᠷ mm Hg). Over half had a history of smoking and 39% had a sub-optimal total cholesterol level > 4 mmol/L. Overall, 62% (376 cases) were treated for corory artery disease (27% with multi-vessel disease and 39% underwent cardiac revascularisation). A further 20% (120 cases) were treated for a cardiac arrhythmia (predomintly atrial fibrillation) and 19% type 2 diabetes mellitus. At 7-14 days post-discharge, 293 (96%) HBI patients received a home visit triggering urgent clinical review and/or enhanced clinical magement in many patients. Conclusions The Young @ Heart intervention is a well accepted and potentially effective intervention to reduce recurrent hospital stay in privately insured cardiac patients in Australia.