<abstract xmlns="http://www.w3.org/1999/xhtml"><sec><h3>Introduction</h3><p>Heart failure is common in the nursing home population and presents many diagnostic and therapeutic challenges. Point-of-care ultrasonography is a bedside method that can be used to assess volume status more reliably than clinical examination. This trial was conceived to test whether point-of-care ultrasonography-guided management improves heart failure outcomes among nursing home residents.</p></sec><sec><h3>Methods</h3><p>Nursing home residents with heart failure will be enrolled in a multi-centre, prospective, randomised controlled trial. Residents will first be screened for heart failure. Patients with heart failure will be randomised in 1:1 fashion into two groups. Nursing home physicians will adjust diuretic therapy according to volume status for six months. Point-of-care ultrasonography will be used in the test group and clinical examination in the control group. The primary endpoint will be heart failure deterioration, defined as a composite of any of the following four events: the need for an intravenous diuretic application, the need for an emergency service intervention, the need for unplanned hospitalisation for non-injury causes, or death from whatever cause.</p></sec><sec><h3>Expected results</h3><p>The expected prevalence of heart failure among nursing home residents is above 10%. Point-of-care ultrasonography-guided heart failure management will reduce the number of deteriorations of heart failure in the nursing home population.</p></sec><sec><h3>Conclusion</h3><p>This study will explore the usefulness of point-of-care ultrasonography for heart failure management in the nursing home population.</p></sec></abstract>

IntroductionHeart failure is common in the nursing home population and presents many diagnostic and therapeutic challenges. Point-of-care ultrasonography is a bedside method that can be used to assess volume status more reliably than clinical examination. This trial was conceived to test whether point-of-care ultrasonography-guided management improves heart failure outcomes among nursing home residents.MethodsNursing home residents with heart failure will be enrolled in a multi-centre, prospective, randomised controlled trial. Residents will first be screened for heart failure. Patients with heart failure will be randomised in 1:1 fashion into two groups. Nursing home physicians will adjust diuretic therapy according to volume status for six months. Point-of-care ultrasonography will be used in the test group and clinical examination in the control group. The primary endpoint will be heart failure deterioration, defined as a composite of any of the following four events: the need for an intravenous diuretic application, the need for an emergency service intervention, the need for unplanned hospitalisation for non-injury causes, or death from whatever cause.Expected resultsThe expected prevalence of heart failure among nursing home residents is above 10%. Point-of-care ultrasonography-guided heart failure management will reduce the number of deteriorations of heart failure in the nursing home population.ConclusionThis study will explore the usefulness of point-of-care ultrasonography for heart failure management in the nursing home population.

Optimisation of Heart Failure Management in Nursing Homes Using Point-of-Care Ultrasonography: Harmonious Trial Rationale and Design

Faculty of Medicine, Department of Family Medicine

Slovenian Journal of Public Health

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

UPORABA OBPOSTELJNE ULTRASONOGRAFIJE ZA IZBOLJŠANJE VODENJA SRČNEGA POPUŠČANJA V DOMOVIH STAREJŠIH OBČANOV: METODOLOGIJA ŠTUDIJE HARMONIOUS

IntroductionHeart failure is common in the nursing home population and presents many diagnostic and therapeutic challenges. Point-of-care ultrasonography is a...

Optimisation of Heart Failure Management in Nursing Homes Using Point-of-Care Ultrasonography: Harmonious Trial Rationale and Design

Article Category: Original scientific article

Published Online: Jun 25, 2020

Page range: 128 - 136

Received: Dec 22, 2019

Accepted: May 07, 2020

DOI: https://doi.org/10.2478/sjph-2020-0017

Keywords
nursing homes, heart failure, point-of-care ultrasonography, volume assessment

© 2020 Vesna Homar et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Optimisation of Heart Failure Management in Nursing Homes Using Point-of-Care Ultrasonography: Harmonious Trial Rationale and Design

Article Category: Original scientific article

Published Online: Jun 25, 2020

Page range: 128 - 136

Received: Dec 22, 2019

Accepted: May 07, 2020

DOI: https://doi.org/10.2478/sjph-2020-0017

Keywordsnursing homes, heart failure, point-of-care ultrasonography, volume assessment

© 2020 Vesna Homar et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
nursing homes, heart failure, point-of-care ultrasonography, volume assessment