Initiative helps minority heart failure patients

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A nurse-led program can improve functioning and reduce hospitalizations among African-American and other minority patients with heart failure, a study shows.

Despite the availability of effective therapies, heart failure “continues to cause substantial hospitalization, and death, especially among African-American and other nonwhite populations,” note the study’s authors in the Annals of Internal Medicine.

In their study, involving 406 mostly African-American and Hispanic heart failure patients, Dr. Jane E. Sisk of the National Center for Health Statistics at the Centers for Disease Control and Prevention in Hyattsville, Maryland and colleagues found that a year-long nurse-led effort focusing on specific problems was more effective than usual care

Half the participants in the study received standard care for heart failure. The other half were counseled by bilingual nurses about their diet, the importance of sticking to their medication, and self-management of symptoms through an initial visit and regularly scheduled follow-up telephone calls.

The nurse managers also talked with patients’ doctors about medication changes that would be helpful.

After 12 months, the patients with nurse managers had had somewhat fewer hospitalizations than patients receiving usual care—143 vs 180. They also had better functioning, based on standard tests.

“These results have important clinical significance,” Sisk’s team says. “The average nurse management patient reported maintained functioning, with a slight limitation in physical activity, but the average usual care patient reported worse functioning and marked limitation in physical activity.”

However, continued contact with the nurse manager may be needed for sustained improvement. The differences favoring nurse management did not continue after 12 months, when the counseling stopped.

SOURCE: Annals of Internal Medicine, August 15, 2006.

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