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Nurse-led heart failure management improved quality of life and was cost-effective

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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) …

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