Key result
A structured, nurse-led care programme for patients with HFPEF did not significantly reduce cardiovascular mortality and readmission rate at 18 months compared to usual care (HR 0.85; 95% CI 0.42-1.73; P=0.658).
Why the study?
Does a structured, nurse-led patient education programme and care plan reduce deaths or hospitalizations in patients with heart failure with preserved ejection fraction?
RCT (n=85)
Single-blind
Does a structured, nurse-led patient education programme and care plan reduce deaths or hospitalizations in patients with heart failure with preserved ejection fraction?
Hazard Ratio: 0.85 (95% CI 0.42–1.73)
p-value: p=0.658
A nurse-led disease management program for HFpEF improved quality of life, functional capacity, and risk factors, but did not significantly reduce mortality or hospitalizations at 18 months.
Nurse-led structured care should not be adopted to reduce CV events in HFpEF; challenges assumptions of benefit on hard endpoints from prior observational data.
BACKGROUND: Disease management programmes (DMPs) improve quality of care for patients with heart failure (HF). However, only a limited number of trials have studied the efficacy of such programmes for patients with heart failure with preserved ejection fraction (HFPEF). OBJECTIVE: To estimate the impact of a structured, nurse-led patient education programme and care plan in general practice on outcome parameters and events in patients with HFPEF. METHODS: Single blinded randomized clinical trial with an intervention over six months and a follow-up during 12 additional months. In the control group, the patients (n = 41) were managed according to Russian national guidelines. Patients in the intervention group (n = 44) received education on individual lifestyle changes and modifications of cardiovascular disease (CVD) risk factors, home-based exercise training and weekly nurse consultations in addition to usual care. RESULTS: Six months after their inclusion, patients in the intervention group significantly improved body mass index, waist circumference, six-min walk test distance, total cholesterol, low-density lipoprotein, left ventricular end-diastolic volume index, quality of life and level of anxiety. After 18 months, there were 11 deaths (25%) or hospitalizations in the intervention group and 12 (29%) in the control group (P = 0.134). Cardiovascular mortality and readmission rate were not reduced significantly after six months of follow-up: the hazard ratio was 0.47 (95% CI: 0.17-1.28; P = 0.197). After 18 months, this was 0.85 (0.42-1.73; P = 0.658). CONCLUSION: This primary care based DMP for patients with HFPEF improved the patients' emotional status and quality of life, positively influenced body weight, functional capacity and lipid profile, and attenuated heart remodelling.
No takes yet. Share an insight, caveat, or question.
Andryukhin et al. (2010) conducted an RCT in Heart failure with preserved ejection fraction (HFPEF) (n=85). Structured, nurse-led patient education programme and care plan vs. Usual care according to Russian national guidelines was evaluated on Cardiovascular mortality and readmission rate at 18 months (HR 0.85, 95% CI 0.42-1.73, p=0.658). A structured, nurse-led care programme for patients with HFPEF did not significantly reduce cardiovascular mortality and readmission rate at 18 months compared to usual care (HR 0.85; 95% CI 0.42-1.73; P=0.658).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: