PRADOC: A Multicenter Randomized Controlled Trial to Assess the Efficiency of PRADO-IC, a Nationwide Pragmatic Transition Care Management Plan for Hospitalized Patients With Heart Failure in France.

Autor: Roubille F; PhyMedExp Université de Montpellier INSERM CNRS Cardiology Department INI-CRT CHU de Montpellier Montpellier France., Labarre JP; Cardiology Clinique du Pont de Chaume ELSAN Montauban France., Georger F; Cardiology Unit Beziers Hospital Béziers France., Galinier M; Fédération des Services de Cardiologie CHU Toulouse-Rangueil Toulouse France., Herman F; Epidemiology and Clinical Research Department University Hospital University of Montpellier Montpellier France., Berdague P; Cardiology Unit Beziers Hospital Béziers France., Nogue E; Epidemiology and Clinical Research Department University Hospital University of Montpellier Montpellier France., Petroni T; Cardiology Clinique du Pont de Chaume ELSAN Montauban France., Delbaere Q; Department of Cardiology Montpellier University Hospital Montpellier France., Malak A; Department of Cardiology Montpellier University Hospital Montpellier France., Robin M; Department of Cardiology Montpellier University Hospital Montpellier France., Prunet E; Department of Cardiology Nimes University Hospital Montpellier University Nimes France., Leclercq F; Department of Cardiology Montpellier University Hospital Montpellier France., Pasquie JL; PhyMedExp Université de Montpellier INSERM CNRS Cardiology Department CHU de Montpellier Montpellier France., Papinaud L; Direction Régionale du Service Médical Occitanie CNAM Montpellier France., Mercier G; Public Health Department Montpellier University Hospital Montpellier France.; UMR IDESP INSERM Montpellier University Montpellier France., Ricci JE; Department of Cardiology Nimes University Hospital Montpellier University Nimes France., Cayla G; Department of Cardiology Nimes University Hospital Montpellier University Nimes France., Duflos C; Public Health Department Montpellier University Hospital Montpellier France.; UMR IDESP INSERM Montpellier University Montpellier France.
Jazyk: angličtina
Zdroj: Journal of the American Heart Association [J Am Heart Assoc] 2024 Aug 06; Vol. 13 (15), pp. e032931. Date of Electronic Publication: 2024 Jul 18.
DOI: 10.1161/JAHA.123.032931
Abstrakt: Background: The PRADO-IC (Programme de Retour à Domicile après une Insuffisance Cardiaque) is a transition care program designed to improve the coordination of care between hospital and home that was generalized in France in 2014. The PRADO-IC consists of an administrative assistant who visits patients during hospitalization to schedule follow-up visits. The aim of the present study was to evaluate the PRADO-IC program based on the hypotheses provided by health authorities.
Methods and Results: The PRADOC study is a multicenter, controlled, randomized, open-label, mixed-method trial of the transition program PRADO-IC versus usual management in patients hospitalized with heart failure (standard of care group; NCT03396081). A total of 404 patients were recruited between April 2018 and May 2021. The mean patient age was 75 years (±12 years) in both groups. The 2 groups were well balanced regarding severity indices. At discharge, patients homogeneously received the recommended drugs. There was no difference between groups regarding hospitalizations for acute heart failure at 1 year, with 24.60% in the standard of care group and 25.40% in the PRADO-IC group during the year following the index hospitalization (hazard ratio, 1.04 [95% CI, 0.69-1.56]; P =0.85) or cardiovascular mortality (hazard ratio, 0.67 [95% CI, 0.34-1.31]; P =0.24).
Conclusions: The PRADO-IC has not significantly improved clinical outcomes, though a trend toward reduced cardiovascular mortality is evident. These results will help in understanding how transitional care programs remain to be integrated in pathways of current patients, including telemonitoring, and to better tailor individualized approaches.
Registration: URL: https://www.clinicaltrials.gov; Unique Identifier: NCT03396081.
Databáze: MEDLINE
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