Nurses Improve Management of Heart Failure

Nurse case managers can improve functioning and reduce hospitalization in African-American and other minority patients who have heart failure (HF) with systolic dysfunction, according to a new study.

In a randomized study involving 406 mostly African-American and Hispanic HF patients, researchers from the U.S. National Center for Health Statistics at the Centers for Disease Control and Prevention (Hyattsville, MD, USA) found that a nurse-led intervention focusing on specific management problems was more effective than usual HF care. In the year-long study, bilingual nurses counseled 203 intervention patients on diet, the importance of sticking to their medication, and self-management of symptoms through an initial visit and regularly scheduled follow-up telephone calls.

A group of 203 control patients received the usual HF care. At 12 months, the patients with nurse managers had modestly fewer hospitalizations (143 compared to 180) compared with patients receiving usual care. They also had better functioning, based on standard tests. The results were published in the August 15, 2006, edition of the Annals of Internal Medicine.

"At the end of the intervention, the average nurse management patient reported maintained functioning, with a slight limitation in physical activity, but the average usual-care patient reported worse functioning and marked limitation in physical activity,” concluded Dr. Jane E. Sisk and colleagues

However, continued contact with the nurse manager may be needed for sustained improvement, the researchers said, noting that the differences favoring nurse management did not continue after 12 months, when the counseling stopped.



Related Links:
National Center for Health Statistics