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  • The addition of a home visit by a cardiac nurse to usual multidisciplinary care reduced deaths and readmissions in patients with chronic congestive heart failure

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The addition of a home visit by a cardiac nurse to usual multidisciplinary care reduced deaths and readmissions in patients with chronic congestive heart failure

https://doi.org/10.1136/ebn.3.2.56

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    Stewart S, Marley JE, Horowitz JD. Effects of a multidisciplinary, home-based intervention on unplanned readmissions and survival among patients with chronic congestive heart failure: a randomised controlled study.Lancet1999 Sept 25;354:1077–83.OpenUrlCrossRefPubMedWeb of Science

    QUESTION: In patients with chronic congestive heart failure (CHF) who are discharged home after acute admission, does the addition of a home visit by a cardiac nurse to usual multidisciplinary care reduce out of hospital deaths and unplanned readmissions?

    Design

    Randomised (concealed), blinded (outcome assessor), controlled trial with 6 months of follow up.

    Setting

    A tertiary referral hospital in Adelaide, South Australia, Australia.

    Patients

    200 patients ≥55 years of age (mean age 76 y, 62% men) who were to be discharged home, had CHF, and had ≥1 previous admission for acute CHF. Exclusion criteria were reversible ischaemia precipitating heart failure, valvular heart disease amenable to surgery, intended heart transplantation, terminal illness, or residence outside of the catchment area. Follow up was complete.

    Intervention

    100 patients …

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    Footnotes

    • Source of funding: not stated.

    • For correspondence: Professor J D Horowitz, Department of Cardiology, Queen Elizabeth Hospital, 28 Woodville Road, Woodville, South Australia 5011, Australia. Fax +61 8 8222 6030.

    • A modified version of this abstract appears in ACP Journal Club.

    • ↵* p-value calculated from data in article.