A nurse-led management intervention improved outcomes compared with usual care.
Many patients do not receive all known effective therapies for congestive heart failure (CHF). Researchers in New York City designed a nurse-led management intervention to address this gap in minority patients, and tested it in a randomized trial of community-dwelling adults with systolic dysfunction (ejection fraction less than 40%)>
Of 406 patients, 46% were black, 33% were Hispanic, and 15% were white; 30% had limited health literacy. Many had diabetes, chronic lung disease, hypertension, or psychiatric illnesses including alcoholism. Over 12 months, significantly fewer hospitalizations occurred in the nurse-management group (143 vs. 180). Physical health–related quality of life (as measured by the 12-item Short Form Health Survey) worsened in the usual-care group and stayed about the same in the nurse-management group — a significant difference.
Comment: Well-designed care management clearly can improve quality of care and outcomes. We still need to determine how to extend these benefits to other diseases and across multiple chronic conditions in the same patient.
— Richard Saitz, MD, MPH, FACP, FASAM
Published in Journal Watch General Medicine September 14, 2006
Citation(s):
Sisk JE et al. Effects of nurse management on the quality of heart failure care in minority communities: A randomized trial. Ann Intern Med 2006 Aug 15; 145:273-83.
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Source : http://general-medicine.jwatch.org/cgi/content/full/2006/914/5