OBJECTIVE: To evaluate the effect of a nurse-led heart failure clinic on drug therapy and hospitalization in a community hospital setting. DESIGN: Prospective, observational study of outpatients referred to a heart failure clinic. Nurses directed drug uptitration and delivered patient education. Utilization and doses of ACE inhibitors and beta-blockers were analyzed as were heart failure related admissions in the years before and after establishing the clinic. RESULTS: 138 patients (median age 68.5 years) were enrolled. After three months 94% of patients were taking an ACE inhibitor and beta-blockade was prescribed for 91%. Mean ACE inhibitor dose relative to target dose after three months was 77+/-30% and mean beta-blocker dose was 53+/-31% of the target dose. Heart failure admissions decreased by 45% after the clinic was established. CONCLUSIONS: Community hospital based heart failure clinics may promote utilization of evidence based drug therapy and cause a substantial decrease in heart failure admissions, producing results comparable to those obtained in studies of university hospital based heart failure management programs.
OBJECTIVE: To evaluate the effect of a nurse-led heart failure clinic on drug therapy and hospitalization in a community hospital setting. DESIGN: Prospective, observational study of outpatients referred to a heart failure clinic. Nurses directed drug uptitration and delivered patient education. Utilization and doses of ACE inhibitors and beta-blockers were analyzed as were heart failure related admissions in the years before and after establishing the clinic. RESULTS: 138 patients (median age 68.5 years) were enrolled. After three months 94% of patients were taking an ACE inhibitor and beta-blockade was prescribed for 91%. Mean ACE inhibitor dose relative to target dose after three months was 77+/-30% and mean beta-blocker dose was 53+/-31% of the target dose. Heart failure admissions decreased by 45% after the clinic was established. CONCLUSIONS: Community hospital based heart failure clinics may promote utilization of evidence based drug therapy and cause a substantial decrease in heart failure admissions, producing results comparable to those obtained in studies of university hospital based heart failure management programs.
Authors: Anne M Gillis; Laurie Burland; Beverly Arnburg; Cheryl Kmet; P Timothy Pollak; Katherine Kavanagh; George Veenhuyzen; D George Wyse Journal: Can J Cardiol Date: 2008-03 Impact factor: 5.223