OBJECTIVES: To determine whether specialist nurse intervention improves outcome in patients with chronic heart failure. DESIGN: Randomised controlled trial. SETTING:Acute medical admissions unit in a teaching hospital. PARTICIPANTS: 165 patients admitted with heart failure due to left ventricular systolic dysfunction. The intervention started before discharge and continued thereafter with home visits for up to 1 year. MAIN OUTCOME MEASURES: Time to first event analysis of death from all causes or readmission to hospital with worsening heart failure. RESULTS: 31 patients (37%) in the intervention group died or were readmitted with heart failure compared with 45 (53%) in the usual care group (hazard ratio=0.61, 95% confidence interval 0.33 to 0.96). Compared with usual care, patients in the intervention group had fewer readmissions for any reason (86 v 114, P=0.018), fewer admissions for heart failure (19 v 45, P<0.001) and spent fewer days in hospital for heart failure (mean 3.43 v 7.46 days, P=0.0051). CONCLUSIONS: Specially trained nurses can improve the outcome of patients admitted to hospital with heart failure.
RCT Entities:
OBJECTIVES: To determine whether specialist nurse intervention improves outcome in patients with chronic heart failure. DESIGN: Randomised controlled trial. SETTING: Acute medical admissions unit in a teaching hospital. PARTICIPANTS: 165 patients admitted with heart failure due to left ventricular systolic dysfunction. The intervention started before discharge and continued thereafter with home visits for up to 1 year. MAIN OUTCOME MEASURES: Time to first event analysis of death from all causes or readmission to hospital with worsening heart failure. RESULTS: 31 patients (37%) in the intervention group died or were readmitted with heart failure compared with 45 (53%) in the usual care group (hazard ratio=0.61, 95% confidence interval 0.33 to 0.96). Compared with usual care, patients in the intervention group had fewer readmissions for any reason (86 v 114, P=0.018), fewer admissions for heart failure (19 v 45, P<0.001) and spent fewer days in hospital for heart failure (mean 3.43 v 7.46 days, P=0.0051). CONCLUSIONS: Specially trained nurses can improve the outcome of patients admitted to hospital with heart failure.
Authors: M Packer; P A Poole-Wilson; P W Armstrong; J G Cleland; J D Horowitz; B M Massie; L Rydén; K Thygesen; B F Uretsky Journal: Circulation Date: 1999-12-07 Impact factor: 29.690
Authors: Hanneke W Drewes; Lotte M G Steuten; Lidwien C Lemmens; Caroline A Baan; Hendriek C Boshuizen; Arianne M J Elissen; Karin M M Lemmens; Jolanda A C Meeuwissen; Hubertus J M Vrijhoef Journal: Health Serv Res Date: 2012-03-14 Impact factor: 3.402
Authors: R L Howard; A J Avery; S Slavenburg; S Royal; G Pipe; P Lucassen; M Pirmohamed Journal: Br J Clin Pharmacol Date: 2006-06-26 Impact factor: 4.335
Authors: Barbara Hanratty; Derek Hibbert; Frances Mair; Carl May; Christopher Ward; Simon Capewell; Andrea Litva; Ged Corcoran Journal: BMJ Date: 2002-09-14