Home-based interventions can save millions, new research reveals

The study provides further support for the application of post-discharge HBI across the full spectrum of patients being hospitalised for chronic forms of heart disease
Heart disease kills more than 18 million people a year worldwide, but new research from the Mary MacKillop Institute for Health and Research says hundreds of lives could be saved if countries used specialist cardiac nurses to visit patients at home as part of a comprehensive follow-up programme known as home-based interventions (HBI).

The  National Health and Medical Research Council funded research, Impact of Nurse-Led, Multidisciplinary Home-Based Intervention on Event-Free Survival Across the Spectrum of Chronic Heart Disease, was published in the academic journal Circulation today.

The study involved 1,226 patients from five Australian states. It found post-discharge patients who received specialist and qualified cardiac nurse-led home-based interventions lived longer than those who received standard care. Using a measurement called Days Alive Out of Hospital (DAOH), the study reported 94 of 612 (15 per cent) patients using home-based interventions died in comparison with 124 of 614 (20 per cent) patients allocated standard care.

Lead researcher and MacKillop Institute director Professor Simon Stewart said the differences between the groups were clinically compelling. “Home-based intervention was associated with significantly prolonged survival,” he said.

Professor Stewart said the research was particularly relevant given Australia’s ageing population. “With an increasingly ageing cardiac patient population in whom multi-morbidity and re-hospitalisations are becoming more common, our positive findings with respect to HBI, as a reflection of the overall benefits of applying successful programmes involving a home-based or transitional care approach to chronic heart disease management, are likely to become more clinically relevant over time,” he said.

“Certainly, there is an increasing pressure to develop cost-effective strategies to mitigate persistently high levels of re-hospitalisation and premature mortality associated with chronic heart disease,” Professor Stewart said. “This study provides further support for the application of post-discharge HBI across the full spectrum of patients being hospitalised for chronic forms of heart disease. The benefits of home-based models of care, with their ability to improve the contextual profiling of affected patients to strengthen factors shown to improve health outcomes are now well described with this study – a first- of-its-kind, in fact, as there has been a paucity of research looking at this issue.”