P585Evaluation of a nurse-led cross intervention program in heart failure

Abstract

Background: Several trials have evaluated the effect of disease management programs (DMPs) in HF, with diverse results. The aim of this study was to develop a simple nurse-led clinic cross intervention program (health education and drug treatment optimization) for patients with heart failure (HF) and assess whether this intervention positively affects the prognosis of patients, their care costs (hospital readmissions) and perceived quality of life (QoL). Methods: Between 2011 and 2013, 127 patients with reduced ejection fraction were prospectively randomly allocated (1:2) to standard care or intervention program. Primary composite endpoint was all-cause mortality and hospital admission. Secondary endpoints were all-cause mortality, all-cause hospital admission, admission for heart failure, time to first admission and QoL improvements (assessed by Minnesota Living with Heart Failure Questionnaire). Results: Mean age ± SD was 75±12 years and 69% were males. An intentionto- treat analysis was performed and, after a median follow-up of 2-years, no differences were found in the primary composite endpoint (58% vs. 57%; p=0.99). Likewise, there were no differences between groups in mortality from any cause or admission from any cause (28% vs. 25%; p=0.79 and 55% vs. 49%; p=0.55 respectively). Time to first admission was similar in both groups (mean ± SD: 277±235 days vs. 249±224 days; p=0.72). However, in the intervention group, admissions for HF were reduced (35% vs. 18%; p=0.04) and QoL related to health was higher (MLHFQ 23.46 vs. 19.8; p=0.04). Conclusions: Nurse-led cross intervention programs significantly improve perceived QoL and reduce hospital admission for HF.