Clinical Implications of a Nurse-Led Heart Failure Clinic at a Rural Japanese Hospital: A Two-Year Single-Center Experience

Abstract

Clinical outcomes in patients with chronic heart failure (HF) remain suboptimal, even in the contemporary era of guideline-directed medical therapy. HF nursing clinics may offer additional benefits by enhancing self-management and improving quality of life in this population. We retrospectively analyzed prospectively collected clinical data regarding a monthly HF nursing clinic conducted between April 2023 and March 2025. The clinic was operated by certified HF nurses and certified HF educators, who consistently followed patients with chronic HF following discharge from an index HF hospitalization. All participants underwent a multidisciplinary conference prior to index discharge. A total of 47 patients (median age: 75 years; 31 [66%] men) were included, with 27 patients (57%) classified as having preserved ejection fraction. Over a median follow-up of 217 (93, 321) days, the median number of clinic visits was 5, and the median counseling duration was 25 (20, 30) minutes per visit. The most frequent counseling topics included psychological support, promotion of self-monitoring and self-management, and dietary guidance. Plasma B-type natriuretic peptide and serum albumin levels improved over the follow-up period, while the estimated glomerular filtration rate remained unchanged. The one-year freedom from HF hospitalization rate was 54%. We report our preliminary two-year experience with a HF nursing clinic led by certified HF nurses and HF educators at a rural Japanese university hospital. These findings are exploratory and may help inform future development of nurse-led multidisciplinary care models. Further studies are needed to validate this approach and better understand its potential clinical implications.