Age‐stratified effectiveness of a nurse‐led heart failure programme: A population‐based study

AIM: Old age is associated with poor outcomes in patients with heart failure (HF). This study aimed to assess the impact of age on the effectiveness of a new integrated, transition-based nurse-led HF programme in a healthcare area with 209,255 inhabitants. METHODS: We conducted a population-based evaluation of all patients discharged from the hospital with International Classification of Diseases, ninth revision, Clinical Modification code for HF as the primary diagnosis in Catalonia between 2015 and 2019. We compared outcomes between patients exposed to the new HF programme with the rest of Catalonia, stratified by age. RESULTS: A total of 77,554 patients with HF were classified into three groups: 15-74, 75-84 and >84 years. In the Bellvitge University Hospital (HUB)-Delta area (3396 HF patients), comparison of the pre-implementation and consolidation periods of the programme showed a decrease in clinically related hospitalisation in the youngest group (hazard ratio [HR] 0.87; confidence interval [CI] 0.84-0.91, p < 0.001), the middle-age group (HR 0.90; CI 0.87-0.93, p < 0.001) and the oldest group (HR 0.83; CI 0.83-0.89; p < 0.001). Similar results were observed for all-cause mortality and readmission. Compared with HF care in the rest of Catalonia, the new programme resulted in a significant reduction in all-cause mortality across all age groups and all-cause hospitalisations among the young and middle-aged groups during the programme's transition and consolidation periods. CONCLUSIONS: Implementation of the new HF programme within a universal-coverage healthcare system was associated with significant reductions in all-cause clinically related hospitalisations and HF readmissions across all age groups.