Standardized Telephonic Case Management in a Hispanic Heart Failure Population
The aim of conducting the research was to determine the effectiveness of a standardized telephonic protocol used as an intervention method for managing diseases. In this case, Riegel, Carlson, Glaser, Kopp and Romero (2012) focused on heart failure disease to examine the effectiveness of the method. The study was conducted in California, an area with a high population of the Hispanic population. In the United States, the Hispanic populations are the risk of developing heart failure than the populations, including the non-Hispanic whites and the African-Americans (Riegel, Carlson, Glaser, Kopp & Romero, 2012).
The research problem was based on the realization that the effectiveness of heart failure management programs had not been tested when in Hispanic participants. The researchers’ objective was to obtain the effectiveness of the intervention method known as ‘At Home With heart Failure’ designed by Pfizer Corporation (Riegel, Carlson, Glaser, Kopp & Romero, 2012). Specifically, Riegel, Carlson, Glaser, Kopp and Romero (2012) used a quantitative study method in which they determined the effectiveness of the method based on the success rates in terms of percentages of the decreasing acute care use as well as cost. Therefore, the researchers focused on the cost, use and outcomes of the method. The researchers varied the use of the method in order to obtain the results. This means that using (or failing to use) the method was the dependent variable in the study. On the other hand, the cost of the method was the dependent variable in the study.
Riegel, Carlson, Glaser, Kopp and Romero (2012) used a randomized controlled clinical trial. In addition, a factorial design was used for data analysis. The study population included two groups- Hispanic population with heart failure (the intervention group) and a control group composed of non-Hispanic population with the same condition.
The researchers obtained a study population of 358 participants (Riegel, Carlson, Glaser, Kopp & Romero, 2012). Out of the total population, 93 individuals (26%) were included in the study sample- 35 were Hispanics (the trial group) and 58 were the control group (Riegel, Carlson, Glaser, Kopp & Romero, 2012). Noteworthy, both males and femamles were included in the study In addition, the study targeted adults with HF. Registered nurses were recruited in the study to act as an avenue for sourcing data. They were tasked with the responsibility of telephoning the patients after they were discharged from the selected hospitals. They provided the patients with care, encouragements, solutions and facilitation of the required services. This means that data was obtained through telephone conversations (Riegel, Carlson, Glaser, Kopp & Romero, 2012). The nurses were supposed to record the data in special forms provided by the researchers.
Data analysis was achieved through statistical analysis. The effectiveness of the method was determined by testing its outcomes in terms of reduced/increased cost and use (Riegel, Carlson, Glaser, Kopp & Romero, 2012). The results show that the resource for acute care among the Hispanics declined significantly, but this observation was also seen in the control group (Riegel, Carlson, Glaser, Kopp & Romero, 2012). However, the results indicated that the lowering of resource use was greater in the trial than the control group (Riegel, Carlson, Glaser, Kopp & Romero, 2012).
The researchers concluded that the populations of Hispanic patients of heart failure are receptive of the case management. They are also responsive to the intervention method. Thus, the cultural, economic and social views of the disease and self-care do not have significant effect on the method (Riegel, Carlson, Glaser, Kopp & Romero, 2012).
The researchers recommend that the method is important in managing patients of HF during home-based self-care. In addition, further studies are required to expand the existing knowledge (Riegel, Carlson, Glaser, Kopp & Romero, 2012).
This study method had a major strength because it worked with control and trial groups, which made it easy to compare and contrast the outcomes. However, it is weak because it relies on statistical data. In addition, it used a relatively small sample population, making it difficult to generalize the results.
Randomized Controlled Trial of Telephone Case Management in Hispanics of Mexican Origin With Heart Failure
The aim of conducting this research was to determine the effectiveness of telephone-based case management of heart failure in a given population. In particular, the effectiveness of this method was determine by the trends in the rate of patient hospitalization, quality of life and reduction in the degree of depression. It is worth noting that most patients of heart failure develop depression after realizing that they are physically disabled.The study was conducted in various hospitals in California, where the population of the Hispanics of Mexican origin is relatively high (Riegel, Carlson, Glaser, Kopp & Romero, 2010).
A quantitative study was used to measure the outcomes of the method in terms of the rate of hospitalizations, improvement of HRQL and degree of patient depression.in this case, Riegel, Carlson, Glaser, Kopp and Romero (2010) used these aspects as the dependent variables that were subject to change when the independent variable (the use of the method) was varied.
Riegel, Carlson, Glaser, Kopp and Romero (2010) used a randomized trial design. The population of interest consisted of individuals of the Mexican Hispanic background with HF. Some 134 participants were enrolled. After randomization, 69 were placed under the trial group and 65 under the control group (Riegel, Carlson, Glaser, Kopp & Romero, 2010). The control group was given the usual care while the trial group was treated with the method of interest. The individuals were aged between 61 and 82 years, with a medium age of 72 years (Riegel, Carlson, Glaser, Kopp & Romero, 2010). About 78.4% were uneducated, with less than high school education and not acculturated to the US society (Riegel, Carlson, Glaser, Kopp & Romero, 2010).
To obtain data, nurses with the ability to speak both English and Hispanic were assigned the tasks of working with the patients (Riegel, Carlson, Glaser, Kopp & Romero, 2010). They managed the patients in the two groups for 6 months and filled some study forms. They collected data on hospitalization rates after the first, third and sixth months of the study. They also measured HRQL and depression using self-report in the 3rd and 6th months. A method known as “intention to treat” was applied to analyze the data.
The results indicate that the rates of hospitalization, outcomes, time spent in the healthcare facility, death rates, depression and improvement of the quality of life were similar in both groups (Riegel, Carlson, Glaser, Kopp & Romero, 2010). It was concluded that other factors might be involved in driving the phenomenon (Riegel, Carlson, Glaser, Kopp & Romero, 2010). Therefore, it is recommended that addition studies be conducted using different approaches in order to examine the effectiveness of the test (Riegel, Carlson, Glaser, Kopp & Romero, 2010).
This is a strong study because it attempts to examine the effectiveness of the method using different dependent variables, which have the capacity to improve outcomes. However, it is a weak method because it relies on statistical data as well as data collected by nurses (rather than the researchers).
References
Riegel, B., Carlson, B., Glaser, D., Kopp, Z., & Romero, T. E. (2010). Randomized Controlled Trial of Telephone Case Management in Hispanics of Mexican Origin With Heart Failure. Journal of Cardiac Failure, 12(3), 211–219.
Riegel, B., Carlson, B., Glaser, D., Kopp, Z., & Romero, T. E. (2012). Standardized Telephonic Case Management in a Hispanic Heart Failure Population. Disease Management and Health Outcomes, 10(4), 241-249.