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dc.contributor.authorStewart, S.
dc.contributor.authorCarrington, M.
dc.contributor.authorMarwick, T.
dc.contributor.authorDavidson, P.
dc.contributor.authorMacDonald, P.
dc.contributor.authorHorowitz, J.
dc.contributor.authorKrum, H.
dc.contributor.authorNewton, P.
dc.contributor.authorReid, Christopher
dc.contributor.authorScuffham, P.
dc.date.accessioned2017-01-30T14:48:38Z
dc.date.available2017-01-30T14:48:38Z
dc.date.created2015-10-29T04:09:34Z
dc.date.issued2011
dc.identifier.citationStewart, S. and Carrington, M. and Marwick, T. and Davidson, P. and MacDonald, P. and Horowitz, J. and Krum, H. et al. 2011. The WHICH? Trial: Rationale and design of a pragmatic randomized, multicentre comparison of home- vs. clinic-based management of chronic heart failure patients. European Journal of Heart Failure. 13 (8): pp. 909-916.
dc.identifier.urihttp://hdl.handle.net/20.500.11937/41154
dc.identifier.doi10.1093/eurjhf/hfr048
dc.description.abstract

Aims: To describe the rationale and design of the Which Heart failure Intervention is most Cost-effective & consumer friendly in reducing Hospital care (WHICH?) trial. Methods: WHICH? is a pragmatic, multicentre, randomized controlled trial that seeks to determine if multidisciplinary management of chronic heart failure (CHF) patients post-acute hospitalization delivered in a patient’s own home is superior to care delivered via a specialist CHF outpatient clinic. The composite primary endpoint is all-cause, unplanned recurrent hospitalization or death during 1218 months of follow-up. Of 688 eligible patients, 280 patients (73 male and 66 principal diagnosis of CHF) with a mean age of 71 ± 14 years have been randomized to home- (n 143) or clinic-based (n 137) post-discharge management. This will provide 80 power (two-sided alpha of 0.05) to detect a 15 absolute difference in both the primary end-point and rate of all-cause hospital stay. Preliminary data suggest that the two groups are well matched in nearly all baseline socio-economic and clinical parameters. The majority of patients have significant co-morbidity, including hypertension (63), coronary artery disease (55), and atrial fibrillation (53) with an accordingly high Charlson Index of Comorbidity Score (6.1 ± 2.4). Perspective: Despite its relatively small size, the WHICH? trial is well placed to examine the relative impact of two of the most commonly applied forms of face-to-face management designed to reduce recurrent hospitalization and prolong survival in CHF patients.

dc.titleThe WHICH? Trial: Rationale and design of a pragmatic randomized, multicentre comparison of home- vs. clinic-based management of chronic heart failure patients
dc.typeJournal Article
dcterms.source.volume13
dcterms.source.number8
dcterms.source.startPage909
dcterms.source.endPage916
dcterms.source.issn1388-9842
dcterms.source.titleEuropean Journal of Heart Failure
curtin.departmentDepartment of Health Policy and Management
curtin.accessStatusOpen access via publisher


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