The WHICH? Trial: Rationale and design of a pragmatic randomized, multicentre comparison of home- vs. clinic-based management of chronic heart failure patients
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...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Journal Article |
| Published: |
2011
|
| Online Access: | http://hdl.handle.net/20.500.11937/41154 |
| _version_ | 1848756065926119424 |
|---|---|
| author | Stewart, S. Carrington, M. Marwick, T. Davidson, P. MacDonald, P. Horowitz, J. Krum, H. Newton, P. Reid, Christopher Scuffham, P. |
| author_facet | Stewart, S. Carrington, M. Marwick, T. Davidson, P. MacDonald, P. Horowitz, J. Krum, H. Newton, P. Reid, Christopher Scuffham, P. |
| author_sort | Stewart, S. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | 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. |
| first_indexed | 2025-11-14T09:06:17Z |
| format | Journal Article |
| id | curtin-20.500.11937-41154 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T09:06:17Z |
| publishDate | 2011 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-411542017-09-13T14:13:45Z The WHICH? Trial: Rationale and design of a pragmatic randomized, multicentre comparison of home- vs. clinic-based management of chronic heart failure patients Stewart, S. Carrington, M. Marwick, T. Davidson, P. MacDonald, P. Horowitz, J. Krum, H. Newton, P. Reid, Christopher Scuffham, P. 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. 2011 Journal Article http://hdl.handle.net/20.500.11937/41154 10.1093/eurjhf/hfr048 unknown |
| spellingShingle | Stewart, S. Carrington, M. Marwick, T. Davidson, P. MacDonald, P. Horowitz, J. Krum, H. Newton, P. Reid, Christopher Scuffham, P. The WHICH? Trial: Rationale and design of a pragmatic randomized, multicentre comparison of home- vs. clinic-based management of chronic heart failure patients |
| title | The WHICH? Trial: Rationale and design of a pragmatic randomized, multicentre comparison of home- vs. clinic-based management of chronic heart failure patients |
| title_full | The WHICH? Trial: Rationale and design of a pragmatic randomized, multicentre comparison of home- vs. clinic-based management of chronic heart failure patients |
| title_fullStr | The WHICH? Trial: Rationale and design of a pragmatic randomized, multicentre comparison of home- vs. clinic-based management of chronic heart failure patients |
| title_full_unstemmed | The WHICH? Trial: Rationale and design of a pragmatic randomized, multicentre comparison of home- vs. clinic-based management of chronic heart failure patients |
| title_short | The WHICH? Trial: Rationale and design of a pragmatic randomized, multicentre comparison of home- vs. clinic-based management of chronic heart failure patients |
| title_sort | which? trial: rationale and design of a pragmatic randomized, multicentre comparison of home- vs. clinic-based management of chronic heart failure patients |
| url | http://hdl.handle.net/20.500.11937/41154 |