Nurse-led heart failure management improved quality of life and was cost-effective
P L Hebert
Dr P L Hebert, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA; Paul.Hebert2@va.gov
QUESTION
Is nurse-led heart failure management cost-effective?
METHODS
Design:
cost-effectiveness analysis of a randomised, assessor-blinded, controlled trial with 1-year follow-up.
Setting:
4 hospitals in Harlem, New York, USA.
Patients:
406 community-dwelling adults (mean age 59 y, 54% men) with heart failure. 46% were non-Hispanic black, 33% were Hispanic, and 15% were non-Hispanic white. Follow-up was 81%.
Intervention:
nurse-led heart failure management (n = 203) or usual care (n = 203). The intervention consisted of 1 in-person visit and periodic telephone calls to educate patients about heart failure and encourage adherence to medications and a low-salt diet, and co-ordination with patients’ physicians to optimise heart failure medications.
Outcomes:
quality-adjusted life-years (QALYs) calculated from quality-of-life scores on the Health Utility Index Mark 3 (HUI3) …
