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

https://doi.org/10.1136/ebn.12.2.59

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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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    Footnotes

    • Source of funding: Agency for Healthcare Research and Quality.