Key result
Nurse-led post-discharge care cuts 12-week CHF rehospitalizations to 5.2% vs 8.0% per person-week.
Why the study?
The study was conducted to determine whether a nurse-led program of care can improve medication adherence, quality of life, rehospitalization rates, and all-cause mortality in chronic heart failure patients.
Does a nurse-led post-discharge telephone care program improve medication adherence, quality of life, and reduce rehospitalization in patients with chronic heart failure (LVEF ≤45%) in China?
RCT (n=152)
Open-label
Assigned into 2 groups based on the last digit of their telephone number (odd to control group, even to intervention group)
No
Does a nurse-led post-discharge telephone care program improve medication adherence, quality of life, and reduce rehospitalization in patients with chronic heart failure (LVEF ≤45%) in China?
A 2-week nurse-led telephone follow-up program after heart failure hospitalization significantly improved 12-week GDMT adherence, quality of life, and reduced HF rehospitalization in a Chinese cohort.
Answers are grounded in this paper and cite their sources.
Supports nurse-led post-discharge programs to reduce HF rehospitalization; extends prior trial evidence to Chinese patients with LVEF ≤45%.
BACKGROUND The aims of the present study were to determine whether a nurse-led program of care can improve medication adherence, quality of life (QoL), rates of rehospitalization, and all-cause mortality for chronic heart failure (CHF) patients. MATERIAL AND METHODS CHF patients were randomly assigned into either a control group or an intervention group. At 12 weeks, patients were followed up to evaluate the rate of medication adherence, QoL (as assessed by SF-12 physical and mental component score [PCS and MCS]), rehospitalization, and all-cause mortality. RESULTS We recruited 152 patients. No significant differences in demographics, comorbidities, CHF severity, or etiology at baseline were observed. At discharge, no significant differences in medications prescription, PCS (46 vs. 45), or MCS (55 vs. 56) were observed. However, at 12-week follow-up, compared to the control group, patients in the intervention group were more likely to keep on medications therapy, with a significantly higher use of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker [73.8% vs. 59.7%], beta-blocker (62.5% vs. 51.4%), and aldosterone receptor antagonist (60% vs. 54.2%). Both PCS (35 vs. 40) and MCS (42 vs. 49) were also significantly lower in the control group versus the intervention groups (P<0.05). Patients in the control group had higher incident rate of rehospitalization (8.0% vs. 5.2% per person-week) than in the intervention group, with an incident rate ratio of 1.54 (95% confidence interval [CI]: 1.06-2.23). CONCLUSIONS A nurse-led discharge program of care can be a cost-effective and feasible approach for management of CHF patients in China.
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You et al. (2020) conducted an RCT in Chronic heart failure (LVEF ≤45%) (n=152). Nurse-led post-discharge program of care vs. Standard care alone (ward nurse discharge education on disease status, medication adherence, low-salt diet, fluid restriction, and daily weight monitoring) was evaluated on Incident rate of rehospitalization due to CHF exacerbation at 12 weeks (IRR 1.54 (control vs. intervention), 95% CI 1.06-2.23). A nurse-led post-discharge program reduced rehospitalization rates vs control (5.2% vs 8.0% per person-week; IRR 1.54 for control vs intervention, 95% CI 1.06-2.23) at 12 weeks in CHF patients.
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