An implementation trial of a telephone-based care management program for patients following myocardial infarction

我们正在试验实施一项创新的电话传递计划，以管理心脏病发作的人。心脏康复计划通常设在澳大利亚的医院，当提供这些计划时，人们必须能够参加。尽管此类计划已被证明在改善心脏病发作后的预后方面非常有效，但至少85%的澳大利亚人在心脏病发作后无法访问和-或由于交通和许多其他障碍而无法参加此类计划。因此，迫切需要找到新的、有效的、负担得起的方式来为心脏病发作后的人们提供心脏康复计划。拟议的电话传递计划将特别适合弱势群体，如那些生活在农村和偏远地区的人，以及目前无法获得以医院为基础的心脏康复计划的土著澳大利亚人。有过心脏病发作的人将从布里斯班三家最大的公立教学医院招募，然后被随机分配到电话传递的心脏康复计划(护理管理干预组)或对照组或普通护理组。护理管理干预组将定期接到澳大利亚国家心脏基金会著名电话支持服务“Heartline”的一位高素质的“护理经理”打来的电话。护理经理将帮助人们管理他们的心脏状况，防止进一步的心脏问题再次发生。还将鼓励人们在关怀经理和一些心脏基金会的教育和互动资源的帮助下，做出必要的生活方式和行为改变，以记录他们的进展。我们预计，在6个月和12个月的随访中，项目或护理管理干预组将比对照组或普通护理组有更好的健康结果。

We are trialling the implementation of an innovative telephone-delivered program for managing people who have had a heart attack. Cardiac rehabilitation programs are generally based in hospitals in Australia and people have to be able to attend the programs when they are offered. Even though such programs have been shown to be very effective in improving outcomes after a heart attack, at least 85% of Australians after a heart attack are either unable to access and-or unable to attend such programs due to transport and many other barriers. So, there is an urgent need to identify new, effective, and affordable ways of delivering cardiac rehabilitation programs to people after a heart attack. The proposed telephone-delivered program will be particularly appropriate for disadvantaged people, such as those living in rural and remote areas as well as Indigenous Australians, who do not currently have access to hospital-based cardiac rehabilitation programs. People who have had a heart attack will be recruited from three of Brisbane's largest public teaching hospitals, and will then be randomly assigned to the telephone-delivered cardiac rehabilitation program (Care Management Intervention group) or to a control or Usual Care group. The Care Management Intervention group will receive regular telephone calls from a highly qualified 'Care Manager' based at the renowned National Heart Foundation of Australia telephone support service, 'Heartline'. The Care Manager will help people to manage their heart condition and prevent the reoccurrence of further heart problems. People will also be encouraged to make necessary lifestyle and behavioural changes with the assistance of the Care Manager and some Heart Foundation educational and interactive resources to record their progress. We expect that the program or Care Management Intervention group will have better health outcomes than the control or Usual Care group at 6 and 12 months follow up.