Improving Outcomes for African Americans with Chronic Heart Failure: A Comparison of Two Home Care Management Delivery Methods

Available data indicate disparity in heart failure (HF) morbidity and mortality among African Americans. African Americans are diagnosed with HF at a younger age, have a more rapid clinical progression, and have higher hospitalization rates related to HF than Whites. Lack of inclusion of African Americans in research studies has been suggested as a possible contributing factor to this disparity. This study presents a secondary analysis from a randomized trial comparing biopsychosocial outcomes for only the African Americans whose HF home management was provided by one of two home care delivery methods—nurse telemanagement (NTM) or nurse home visits. Results indicate significantly higher self-efficacy, home care satisfaction, and quality of life, with significantly lower symptom distress, HF rehospitalization, and intervention charges for African Americans whose HF home management was delivered by the NTM method. These data suggest, independent of race, that NTM may be more efficient and effective as a delivery method for HF home management.