DEventer-ALkmaar Heart failure Project.

Conclusion: We showed that a heart failure clinic involving an intensive, protocolised intervention by both a clinician and a cardiovascular nurse, substantially reduces hospitalisations for worsening HF and/or all cause mortality and improves functional status, while decreasing health care costs, even in a country with a primary care-based health care system.

To determine whether a regular and protocolised intervention at a heart failure (HF) clinic by a combination of a clinician and a cardiovascular nurse, both trained in HF, reduces hospitalisation for worsening HF and/or all cause mortality and improves functional status (including left ventricular ejection fraction, NYHA class and quality of life) in patients with NYHA class III or IV HF.

N/A

Methods:

240 patients were randomly allocated to the 1-year intervention (n=118) or usual care (n=122). The intervention consisted of nine visits with increasing intervals to a combined, intensive physician-and-nurse-directed HF outpatient clinic, starting a week after hospital discharge or referral from the outpatient clinic. Verbal and written comprehensive education, optimisation of treatment, easy access to the clinic, recommendations for exercise and rest, and advice for symptom monitoring and self care were provided. Usual care included non-protocolised outpatient visits initialised by individual cardiologists in the cardiology departments involved.