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Nurse-led heart failure clinics improve survival and self-care behaviour in patients with heart failure: Results from a prospective, randomised trial
Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0002-4259-3671
Department of Medicine, County Hospital Ryhov, Jönköping, Sweden and chool of Social and Health Sciences, Halmstad University, Halmstad, Sweden and Unit of Research and Development in Primary Health Care, Jönköping, Sweden .
Linköping University, Department of Medicine and Care. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Department of Health and Society, Center for Medical Technology Assessment. Linköping University, Faculty of Health Sciences.
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2003 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 24, no 11, 1014-1023 p.Article in journal (Refereed) Published
Abstract [en]

Aim The aim of this trial was to prospectively evaluate the effect of follow-up at a nurse-led heart failure clinic on mortality, morbidity and self-care behaviour for patients hospitalised due to heart failure for 12 months after discharge.

Methods A total of 106 patients were randomly assigned to either follow-up at a nurse-led heart failure clinic or to usual care. The nurse-led heart failure clinic was staffed by specially educated and experienced cardiac nurses, delegated the responsibility for making protocol-led changes in medications. The first follow-up visit was 2–3 weeks after discharge. During the visit the nurse evaluated the heart failure status and the treatment, gave education about heart failure and social support to the patient and his family.

Results There were fewer patients with events (death or admission) after 12 months in the intervention group compared to the control group (29 vs 40, p=0.03) and fewer deaths after 12 months (7 vs 20, p=0.005). The intervention group had fewer admissions (33 vs 56, p=0.047) and days in hospital (350 vs 592, p=0.045) during the first 3 months. After 12 months the intervention was associated with a 55% decrease in admissions/patient/month (0.18 vs 0.40, p=0.06) and fewer days in hospital/patient/month (1.4 vs 3.9, p=0.02). The intervention group had significantly higher self-care scores at 3 and 12 months compared to the control group (p=0.02 and p=0.01).

Conclusions Follow up after hospitalisation at a nurse-led heart failure clinic can improve survival and self-care behaviour in patients with heart failure as well as reduce the number of events, readmissions and days in hospital.

Place, publisher, year, edition, pages
2003. Vol. 24, no 11, 1014-1023 p.
Keyword [en]
Heart failure, Heart failure clinics, Mortality, Nursing, Patient education, Self-care
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-46609DOI: 10.1016/S0195-668X(03)00112-XOAI: oai:DiVA.org:liu-46609DiVA: diva2:267505
Note

On the day of the defence day the status of this article was a manuscript

Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Caring for patients with chronic heart failure
Open this publication in new window or tab >>Caring for patients with chronic heart failure
2001 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to describe and evaluate patient education and nurse-led follow up for patients with heart failure. Descriptive designs were used to map out the nurse-led heart failure care in Sweden (I) and to identify factors influencing compliance with prescribed treatment in patients with chronic heart failure.(II) An interactive computer-based multimedia program for the education of patients with heart failure was developed and tested (III) and the effects on knowledge, compliance and quality of life evaluated in a randomised study. (IV) The effects of nurse-led heart failure clinics on mortality, morbidity, health-related quality of life and self-care behaviour in patients hospitalised due to heart failure were also evaluated in a randomised study.(V) Heart failure nurses and nurse-led heart failure clinics were introduced in Sweden in 1990. After 8 years the model has  spread to two thirds of the Swedish hospitals. In total 148 heart failure nurses were involved in education and follow up of patients with heart failure. (I) The compliance with therapeutic regimens was influenced by inward factors; the personality of the patient, the disease and the treatment and outward factors; social activities and relationships to family, friends and health care professionals.(II) The patients with heart failure were satisfied with computer-based education and positive in their attitude towards the computer. There was no need for computer experience in order to run an interactive computer-based program and high age was not a problem for using the program independently.(III) Computer-based education gave increased and more lasting knowledge about heart failure compared to traditional teaching, but compliance was not improved by single-session education. Quality of life was improved after 6 months by both traditional and computer-based education, but only for the men. (IV) Follow up after hospitalisation at a nurse-led heart failure clinic improved survival and selfcare behaviour in patients with heart failure as well as reduced the number of events, readmissions and days in hospital. (V)

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2001. 72 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 708
Keyword
caring, compliance, computer-based education, follow up, heart failure, intervention, nurse-led heart failure clinics, morbidity, mortality, patient education, quality of life, self-care
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-27544 (URN)12204 (Local ID)91-7373-144-7 (ISBN)12204 (Archive number)12204 (OAI)
Public defence
2001-12-10, Berzeliussalen, Universitetssjukhuset, Linköping, 09:00 (Swedish)
Opponent
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2013-09-03Bibliographically approved

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Strömberg, AnnaLevin, Lars-ÅkeDahlström, Ulf

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