Key result
A Clinical Nurse Specialist intervention did not significantly improve overall Health Status compared to conventional rehabilitation at 12 weeks, although it significantly improved self-care behavior.
Why the study?
Does a Clinical Nurse Specialist intervention with telephone follow-up improve health status and self-care behavior in patients with mild to moderate heart failure after completing hospital-based rehabilitation?
Does a Clinical Nurse Specialist intervention with telephone follow-up improve health status and self-care behavior in patients with mild to moderate heart failure after completing hospital-based rehabilitation?
Absolute Event Rate: 0.71% vs 0.66%
p-value: p=0.21
A nurse-led telephone follow-up intervention after hospital-based rehabilitation did not significantly improve overall health status compared to usual care, though it may help reduce patient anxiety.
Nurse-led telephone follow-up does not improve health status in mild-moderate HF post-rehabilitation; leaves open effects on self-care behavior.
Introduction: Living with heart failure is serious and call for long term rehabilitation care. Rehabilitation elements for patients with Heart Failure are based on the recommendations from the European Society of Cardiology and focuses on self-care and adherence in general. The aim of this study was, therefore, to test a protocol for rehabilitation of patients after completing rehabilitation in the outpatient clinic. Method: The study design is quasi-experimental. Patients in the control group follow the conventional rehabilitation. For the patients in the intervention group an individual rehabilitation plan was prepared and followed up by telephone after 4 and 12 weeks. For all patients Health Status were measured with Short Form 36 and EQ5D. Results: One hundred and sixty-two patients are included in the study of which 137 (84.6%) consented. There were no differences in total self-care behavior between the groups at baseline and at follow-up after 4 and 12 weeks. Within the control group no changes in the self-care score from baseline to follow-up were observed. Total EQ5D scores showed no significant differences between the groups at baseline. Subgroup analyses showed a significant difference in usual activities and decrease in anxiety/depression in the intervention group with a within-group increase from 34.4 percent at baseline to 51.4 percent after 12 weeks (p = .0002). No between-groups differences at 4 weeks or 12 weeks were observed. Conclusion: No significant increase in Health Status between groups were found. Subgroup analysis showed a significant within-group decrease in development of anxiety in the intervention group from baseline to twelve weeks. There may be a correlation between the increase in self-care behavior in patients in the intervention group after 12 weeks and a reduction in anxiety.
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Larsen et al. (2014) studied Heart failure (n=162). Clinical Nurse Specialist intervention vs. Conventional rehabilitation was evaluated on EQ5D Total score at 12 weeks (p=0.21). A Clinical Nurse Specialist intervention did not significantly improve overall Health Status compared to conventional rehabilitation at 12 weeks, although it significantly improved self-care behavior.
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