主要护理 在出院后遵守心力衰竭指南,评估和常规管理 (PATHFINDER):一个随机对照试验
Liying Dai1, Tashi Dorje2, Jan Gootjes3
1Curtin School of Allied Health, Curtin University, Perth, Australia.
ESC heart failure
|February 23, 2026
概括
一项新的干预措施显著改善了初级保健中心力衰竭 (HF) 准则的遵守. 接受住院支持的患者表现出更好的药物治疗和心脏康复 (CR) 使用.
科学领域:
- 心脏病学 心脏病学
- 主要护理医学 医疗保健
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在初级保健中实施基于证据的心力衰竭 (HF) 管理指南存在挑战.
- 遵守药理和非药理HF指导方针对于最佳的患者结果至关重要.
研究的目的:
- 评估一项多方面的干预措施,旨在加强在初级保健环境中遵守HF管理指南.
- 评估基于医院的支持对心力衰竭患者转移到初级保健的指南遵守的影响.
主要方法:
- 一项随机对照试验,涉及225名住院患有HF的患者.
- 干预组接受了住院教育,出院后的计划与心脏康复 (CR) 转诊,并计划了初级保健后续检查与药物定位支持.
- 对照组接受了通常的护理. 6个月后测量的主要结果:遵守五种关键的HF治疗方法.
主要成果:
- 与对照组 (28.7%;p<0.01) 相比,干预组中获得主要结果的比例显著增加 (61.8%).
- 干预组实现主要结果的可能性是干预组的6.27倍.
- 改善的原因是ACEI/ARB/ARNI和β-阻断剂处方的更高率,以及CR转诊的增加.
结论:
- 基于医院的过渡护理显著改善了在初级保健中遵守指南推的药理和非药理心力衰竭管理.
- 实施这种过渡性护理过程有可能改善心力衰竭患者的临床结果.
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