Table
of Contents
Appendix B
Table B1. Interventions on recruited
patients inpatient
Study,
Year
Country |
Followup
Duration
(Intervention y) |
Total
N Analyzed |
Mean
Age/%
Male |
Severity of
CHF |
Intervention components |
Control Description |
Quality
Applicability |
| Atienza 2004 Ojeda 2005 Spain |
1.4y
(1999-2000) |
338 |
69/62% |
NYHA III/IV 50% LVEF% 36 |
Cardiologist led education on
disease management and reinforcement; individual strategies
to self-care, medication compliance telephone followup; heartclinic
visit every 3 mo |
Received discharge planning with
routine hospital protocol and followed by PCP and cardiologists
not participating in the study |
A Mod |
| Barth, 2001 USA |
3 mo |
34 |
78/59% |
NYHA: nd LVEF%: nd |
At the time of discharge as per
the hospital procedure, routine discharge teaching by the
hospital nursing staff included instructions on activity,
diet, activities of daily living, medication, follow up appointments
and when to contact the physician. Nurse led telephone reinforcement
of the education on daily weight assessment, CHF symptoms,
fluid and salt intake, and medication adherence. Made phone
contact for first 72 hrs post discharge and 72 hrs later
and then every 2 weeks for 3 mo |
Routine care: received only the
routine discharge teaching at the time of discharge (as described
in the intervention arm) |
C Nar |
| Capomolla 2002 Italy |
12 mo
(1999-2000) |
234 |
57/93% |
NYHA III/IV 35% LVEF% 29 |
Multidisciplinary interventions
including cardiovascular risk stratification, tailored therapy,
physical training, counseling, checking clinical stability,
correction of risk factors for hemodynamic instability, and
health care educationA |
At discharge patients were referred
to their community primary care physician and cardiologists
or cardiology dept |
B Mod |
| Cleland, 2005 EU |
7-8 mo
(2000-2002) |
333 |
67/72% |
NYHA III/IV 31% LVEF <25% = 48% |
Home telemonitoring with electronic
weighing scales; an automated sphygmomanometer; single lead
ECG and Nurses telephone support |
Management plan sent to primary
care physician who implemented it Usual care + Nurses telesupport |
B Wide |
| Cleland, 2005 EU |
7-8 mo
(2000-2002) |
248 |
67/72% |
NYHA III/IV 31% LVEF <25% = 48% |
Home telemonitoring with electronic
weighing scales; an automated sphygmomanometer; single lead
ECG and Nurses telephone support |
Management plan sent to primary
care physician who implemented it |
B Wide |
| Cline, 1998 Sweden |
12 mo
(1991-1993) |
190 |
76/53% |
NYHA 2.6 LVEF mean 31.6% |
Patients received an education
programmed from HF nurse consisting of two 30-minute visits.
2 weeks after discharge patients and their families were
invited to a one-hour group education session led by the
HF nurse. Patients were also offered a 7 day medication dispenser
if deemed appropriate. Patients were followed up at a nurse
directed o/p clinic and there was a single prescheduled visit
by the nurse at 8 mo. after discharge. Patients encouraged
contacting the study nurse at their discretion, if unsure,
if diuretic adjustments did not ameliorate symptoms in 2-3
d, or if there were “profound changes in self management
variables.” Patients were offered cardiology outpatient
visits 1 and 4 months after discharge. |
Followed up at the outpatient
clinic in the department of cardiology by either cardiologists
in private practice or by primary care physicians as considered
appropriate by the discharging consultant. |
C Mod |
| Del Sindaco, 2007 USA |
2 y
(2001-2002) |
236 |
77/51% |
NYHA: II 32 (37.2%), III 44 (51.2%), IV 10 (11.6%) LVEF%:
mean 33.5 ± 11 |
Managed by a cardiologist, two
to four nurses and patient's primary care physician. 1) According
to the guidelines components were discharge planning, continuing
education, therapy optimization, improved communication with
healthcare providers, early notice to signs and symptoms,
and flexible diuretic regimen. 1. Nurses home phone calls
2. Visit with a primary care physician 1 to 2 weeks of discharge
including reinforcement of education and optimization of
therapy. |
Usual care: all treatments and
services ordered by their primary care physician and/or personal
cardiologist Vital status and events were recorded by means
of phone calls every 6 mo |
A Wide |
| Dunagan, 2005 USA |
6 mo
(1999) |
151 |
76/41% |
NYHA: 78% LVEF% <40%: 74% |
Nurse led education intervention,
promotion of self management skills, appropriate diet and
adherence to prescribed meds and telephone followup + Usual
care |
Usual care as provided by primary
physician who provided educational packets at the time of
hospitalization |
C Wide |
| Goldberg, 2003 US |
6 mo
(1998-2000) |
280 |
58/70 |
NYHA III/IV 100% LVEF% <21% |
Nurse led education about heart
failure, including advice on daily weights, dietary restrictions
including sodium and fluid, and signs and symptoms of heart
failure decompensation, increased communication with providers
encouraged, Technology- based telephone HF monitoring (AlereNe
monitoring using the DayLink monitor) |
Standard outpatient heart failure
therapy in dedicated heart failure program. This included
additional nursing resources. |
B Wide |
| Harrison, 2002 Canada |
12 wk
(1996-1998) |
192 |
76/55% |
NYHA III/IV: 77% LVEF: nd |
Comprehensive, evidence based
education programmed for heart failure self-management. A
nursing transfer letter to the home care nurse detailing
clinical status and self-management needs. Phone call from
hospital nurse to patient within 24 hours of discharge. Minimum
of two-community nurse visits within two weeks of discharge. |
Ideally a multidisciplinary discharge
plan within 24 hours of admission and weekly discharge planning
meetings. Regional home care co-coordinator consults with
hospital team as required and may meet patients and their
families. Immediately before discharge physician completes
referral form for home care and necessary services and supplies
are communicated with the home nursing agency. |
A Wide |
| Jaarsma, 2000 Netherlands |
9 mo
(1994-1997) |
179 |
72/60% |
NYHA III/IV 100% LVEF% 36 |
Nurse led intensive education
including symptoms of CHF, sodium restriction, fluid balance
and compliance, telephone contact, home visits once per week
and education, increased communication with providers |
Nurse or physician provided education
about medication and lifestyle |
C Wide |
| Kasper 2002 USA |
~9 mo
(1996-1998) |
200 |
64/61% |
NYHA III 56% LVEF% 27 |
Cardiologists designed individualized
treatment plan (Usual care) + Nurse telephone followup; monthly
clinic visits with nurses; patients received pill sorter,
correct medications, list of dietary and exercise recommendations,
and education material |
CHF cardiologist designed treatment
plan for each patient and documented this in patient's chart |
B Mod |
| Koelling 2005 USA |
~6 mo
(2001-2002) |
223 |
65/58% |
LVEF%: 26 |
Patient education program including
60 min one on one and one time session with a nurse educator,
disease and pharmacotherapy management, Salt and water intake
management, daily weight monitoring, self-care behaviors
+ usual care |
Standard heart failure specific
discharge information Usual care |
A Mod |
| Laramee, 2003 |
3 mo
(1999-2001) |
287 |
71/54% |
NYHA III/IV 38% LVEF Mod/severe 90% |
Education and early discharge
planning and co-ordination of care by nurse case manager;
patients received a educational booklet, weight logs, medication
lists, a guide for measuring sodium intake, weigh scales
and pill boxes; reinforced educational plan and telephone
followup |
Standard terr1tary hospital care,
including opportunity for social services evaluation, dietician
consult etc. and home care service on discharge. Post-discharge
care conducted by primary care physician |
B Mod |
| Ledwidge, 2005 Ireland |
2 y |
130 |
68/68% |
NYHA: IV LVEF%: 39+12 |
Extended heart failure program
(EP) 12 weeks of weekly telephone calls from specialist HF
nurses (mostly the nurse who had managed the pt during the
1st 3 months following discharge) Specialist nurse-led education
and specialist dietician consults on 3 or more occasions
during index admission Telephone contact by HF nurse specialist
weekly until 12 weeks. Telephone calls determined clinical
stability, address questions/concerns and revise key education
points deemed necessary by nurse (on daily weight monitoring,
disease and medication understanding, compliance with therapy
and dietary salt restriction.) |
Standard care (SP) group. |
B Mod |
| McDonald 2002; Ledwidge, 2003 Ireland |
3 mo
(1998-2000) |
98 |
71/63% |
NYHA nd LVEF% 36 |
Specialist nurse-led education
including daily weight monitoring, disease and medication
understanding and salt restriction. Telephone followup and
education reinforcement + usual care |
Usual care description not documented |
B Mod |
| Linne 2006 Sweden |
6 mo
(1998-2002) |
224 |
70/66% |
LVEF <40% |
Standard information + Additional
interactive CD-educational program at and 2 wk after discharge.
CD educational program includes disease symptoms and treatment,
reasons for deterioration of disease, fluid intake, medication
understanding |
Standard information on the inpatient
ward |
C Mod |
| Lopez, 2006 Spain |
(2000-2002) |
134 |
75/41% |
NYHA III 56% LVEF% 27 |
Active Intervention program
Information: the day of hospital discharge, a personal
interview with patient and his caregiver a. information
on the disease b.diet education c. information on drug
therapy contact telephone Telephone strengthening monthly
during the first 6 mos of followup and subsequently ever
2 months, a telephone call was made to the home of the
patient. |
“standard care” not
further defined. However, during regular followup visits
(at 2,6, and 12 months after discharge) the cardiologist
carried out a conventional clinical assessment according
to the standard practice. Pharmacists evaluated the following
parameters: treatment compliance (was patient reliable, partially
reliable, non-reliable), quality of life measurement *EuroQoL
scale), patient satisfaction with the care received (Catalan
Health Department, asking patient about the care and information
received and asking patient to score 0 to 10 in an analogical
scale). |
B Mod |
| Naylor, 2004 USA |
12 mo
(1997-2001) |
239 |
76/40% |
NYHA nd LVEF<45% 86% |
A standard orientation and training
program guided by a multidisciplinary team of heart failure
experts to prepare advanced practice nurse (APN); Use of
care management strategies; home visits by APN |
Non advanced practice nurse care.
Attending physician planned the discharge date, liaison nurses
facilitated referrals to home care services in patients'
residencies |
B Wide |
| Nucifora 2006 Italy |
6 mo
(1999-2001) |
200 |
73/62% |
NYHA III/IV: 67% LVEF <45%: 58% |
Nurse led education including
disease and pharmacological treatment, sodium restriction
and fluid intake management, Weight control and physical
activities, and Other self-care behaviors; facilitated telephone
followup; scheduled visits with an internist |
Preexisting routine post-discharge
care Follow up with their primary care physician as usual |
B Wide |
| Rich 1993 US |
3 mo
(1988-1989) |
98 |
79/40% |
NYHA: mean=2.7 |
During index hospitalization:
Daily education visits by study nurse specialist. Dietician
visit with individualized 1.5-2.0 g sodium diet. Medication
review by geriatric cardiologist with patient/care givers.
Study nurse taught patients about meds and dosing cards.
Social worker and home care team visited patient. After discharge:
Home care team nurse visited within 48 hrs. 2 more home care
team nurse visit in 1st wk. Study nurse phone patient to
assess progress. |
Conventional medical care determined
by patient's physician. |
B Mod |
| Rich 1995 USA |
3 mo
(1990-1994) |
282 |
79/26% |
NYHA mean 2.4 LVEF% 44 |
Multidisciplinary treatment strategy
including inpatient visits by specialist nurse, dietician,
medication review by geriatric cardiologist, nurse led education
about medications, dosing, and adverse effects; weigh scales,
instruction and daily weight charts; social worker and the
home care team visits |
Standard treatment and services
ordered by primary physician |
B Mod |
| Rainville 1999 USA |
12 mo
(1996-1997) |
34 |
73/50% |
NYHA III/IV: 94% LVEF: nd |
Before discharge, pharmacist
reviewed pathology and treatment of HF, weight monitoring
and risk modifications with patient/care giver. Patient given
brochure, video, weight log and medication organizer. After
discharge, pharmacist phoned within 3 days, at 7, 90 days
and 12 months |
Routine care and preparation
for discharge including: written prescription, physician
discharge instructions, nurse review of diet, treatment plans,
medications, and drug info sheets |
C Mod |
| Sethares 2004 US |
3 mo
(1999-2000) |
70 |
76/52% |
LVEF%: 41.45 ± 18 SD |
Research nurse tailored intervention
to perceived benefits and barriers to self-care of HF that
were identified by persons with HF at each time period (in
hospital, 1 week and 1 month after discharge). |
Usual care: discharge teaching
by a unit staff nurse and written educational sheets describing
the uses, side effects, and frequency of any ordered mediations. |
B Wide |
| Stewart 1998 Australia |
6 mo
(nd) |
97 |
76/45% |
NYHA III/IV 51% LVEF%: 38 |
Before discharge, study nurse
counseled treatment regimen compliance and reporting of any
sign of clinical deterioration. 1 week after discharge a
single home visit by the study nurse and pharmacist. Patients
assessed for medication knowledge and compliance. Patients
with poor knowledge were offered counseling, a pill remainder
container, monitoring by caregivers, medication information
and remainder card and referral to a community pharmacist
for more regular review. The study nurse coordinated with
the primary care physician for any further intensive followup
thereafter |
Appointments with the primary
care physician or cardiologist within 2 weeks of discharge.
27% received home support by domiciliary care or community
nurse visits |
B Mod |
| Tsuyuki 2004 USA |
6 mo
(1999-2000) |
276 |
81/58% |
NYHA III or IV: 40% LVEF%: mean EF 32% |
Before discharge: Evaluation
if dosage of ACE-I was appropriate, all meds were reviewed,
recommendations made to optimize other HF therapies and monitored
daily thereafter. After discharge: Patient support program
covered 5 basic areas: salt and fluid restriction, daily
weighing, exercise alternating with rest periods, proper
medication use, early recognition of worsening of symptoms
Education material available on website for download. Patients
received adherence aids: a medication organizer, medication
administration schedule, daily weight log. Telephone followup
to reinforce the education for self care behaviors, newsletters,
clinical events, physician contact for ACE-I initiation and
titration |
General heart disease pamphlet
before discharge, but no formal counseling. Followup consisted
of monthly telephone contact for a period of 6 mo to ascertain
clinical events |
B Mod |
Table B2: Interventions post discharge
Study, Year
Country |
Followup
Duration
(Intervention y) |
No.
Analyzed |
|
Mean
Age |
Severity of
CHF |
Intervention components |
Control Description |
Quality
Applicability |
| Int |
Cont |
Male% |
| Benatar 2003 USA |
3 mo
(1997-2000) |
108 |
108 |
67/39% |
NYHA III or IV: 100% LVEF%: 38.1 |
Daily home telemonitor through
internet monitored by cardiac nurse |
Home nurse visits (specialized
cardiac nurses): Detailed discussions during first 4 visits:
diet, symptom recognition, and compliance with medication
regimens Further visits: on patients' symptoms and vital
signs with physician notification if needed |
B Wide |
| Blue 2001 Scotland |
12 mo
(1997-1998) |
84 |
81 |
74/64% |
NYHA III or IV:76% LVEF%: nd |
Specialist HF nurse visited home
within 48 hrs of discharge, with visits every 3 months after
6 week visit. Patient educated bout HF and treatment, self-monitoring,
medication review and psychological support. Scheduled telesupport
every other month. |
Patients managed as usual by
the admitting physician and then primary care physician |
A Wide |
| Capomolla 2004 Italy |
11 mo
(2000-2001) |
67 |
66 |
57/93% |
NYHA III/IV 49% LVEF% 29 |
Telemonitoring. Nurse led education
about the illness; therapeutic programs, self management
of signs and symptoms, diet and fluid recommendations, domestic
and activities counseling |
Community care. At discharge
patients were referred to their community primary care physician
and cardiologists or cardiology dept |
C Mod |
| DeBusk 2004 USA |
12 mo
(1998-2000) |
228 |
234 |
72/48% |
NYHA III/IV 50% LVEF %:28%<0.40 and 31% >0.40 |
Nurse led standardized telephone
mediated intervention including initial education session
with a videotape, baseline telephone counseling session,
nurse initiated followup telephone contacts, pharmacologic
treatment management, nurse initiated communication with
physicians + usual care |
Usual care Instruction on diet,
drug adherence, physical activity and response to changing
symptoms |
B Mod |
| Doughty 2002 New Zealand |
12 mo
(1997-1998) |
100 |
97 |
60% |
NYHA III 76% LVEF% 30.6 |
General practitioner led outpatient
review at the heart failure clinic; one to one education
with the study nurse, education booklet provided; patient
diary for daily weights, treatment records, telephone followup
with GP, 6 wkly clinic visits, group education session with
cardiologist and nurse about disease, monitoring daily weight,
action plan for weight changes, medication, exercise, diet |
Usual care. Continued
care of their GP with additional follow-up measures as usually
recommended by the medical team responsible for their in-patient
care. |
A Wide |
| Ducharme 2005 Canada |
6 mo
(1998-2000) |
115 |
115 |
68/73% |
NYHA: III or IV LVEF%: 35% |
Mulitidisciplinary care clinic:
cardiologists, nurses, dieticians, social worker, etc; Evaluated
and observed for up to 5 hrs; Nurse telephone followup 72
hr post discharge and monthly once, or frequently as needed
basis; One to one education by study nurse about clinical
condition to the patient/ family members complimented with
a record maintenance by the patient; Reinforcement of patient
education, dietary instructions, interaction of OTC with
meds at each subsequent clinic visit |
Patients received treatment and
appropriate follow-up according to attending cardiologist |
B Mod |
| Ekman 1998 Sweden |
5 mo
(1994-1996) |
79 |
79 |
80/58% |
NYHA mean 3.2 LVEF% 43 |
Specialist nurse led patient
education about their treatment and symptoms of clinical
deterioration, tailored care plan with individualized treatment
goals, access to clinic nurses during business hours, notebook
for daily weight monitoring, treatment and information about
clinical deterioration, and nurse initiated telephone followup |
The patients were managed in
accordance with current clinical practice, i.e., the patient
was treated and followed by a general practitioner and visited
the emergency room if symptoms worsened. |
B Narrow |
| Holland 2007 UK |
6 mo |
149 |
144 |
78/64% |
NYHA: III/IV: 67% LVEF%: nd |
Community Pharmacist arranged
home visit, within 2 weeks of discharge; Educated patient/carer
about HF and their drugs; Gave basic exercise, dietary, and
smoking cessation advice; Encouraged completing of sign and
symptom monitoring diary; Fed back recommendations to GP;
Fed back need for drug adherence aid to local pharmacist |
Usual care not described in the
study |
A Mod |
| Jerant 2001 USA |
6 mo
(1998-2000) |
13/12 |
12 |
67/71: 46%/42% |
NYHA (III/IV): 31%/33% LVEF% 54%/50% |
Intervn 1: Home telecare
with video-conferencing and electronic stethoscope. Nurse
telephone support home telecare delivered via a 2-way video-conference
device with an integrated electronic stethoscope; received
scheduled home telecare visits Intervn 2: nurse telephone
calls; received scheduled phones calls During all in-person,
telecare, and telephone encounters, the study nurse used
the Visiting Nurse Association CCHF Care Steps to guide patient
assessment: vital signs, ADL, med use, dietary factors etc. |
‘Usual outpatient care'
was not described further |
C Narrow |
| Krumholz, 2002 USA |
12 mo
(1997-1998) |
44 |
44 |
76/57% |
NYHA(III/IV) LVEF% 38 |
Cardiac nurse led consultation
on five sequential care domains including patient knowledge
of illness, relation between medication and illness, relation
between health behaviors and illness, symptoms and signs
of deterioration, nurse initiated scheduled telephone calls |
Received all usual care treatments
and services ordered by their physicians. |
C Mod |
| Mejhert 2004 Sweden |
18 mo
(1996-1999) |
103 |
105 |
76/56% |
NYHA III or IV: 42% LVEF%: 34% |
When patient pays visits to the
outpatient program, he/she is encouraged to keep in contact
with the nurse. Each visit the nurse: vital signs, weight,
lab, ECG workup; optimizes meds if needed; instructs patients
to monitor weight, symptoms of deterioration, good compliance
of meds, diet advice, and other self care behaviors Information
repeated in booklets and computerized educational programs |
Undergo initial evaluation with
their general practitioners and are monitored by a heart
failure plan in the primary care setting |
B Mod |
| Morcillo 2005 Spain |
6 mo
(2001-2002) |
34 |
36 |
70/64% |
NYHA III or IV: 74% LVEF% (mean): 35.4% |
One week after discharge the
nurse visited patient's home one time for: education of medication,
signs and symptoms of the disease and treatment compliance;
fluid and diet management and self care habits; discussion
of prophylactic vaccinations + identical conventional care
as the control group |
Conventional care based on best
available evidence + scheduled outpatient followup with attending
physicians |
C Mod |
| Rieigel 2002 USA |
6 mo
(nd) |
130 |
228 |
73/49& |
NYHA III or IV: 98% LVEF% (mean): nd |
Telephonic case management by
a RN case manager using decision-support software. RN contact
patient at a frequency guided by software and judgment of
case manager based on patient's symptoms, needs. |
Usual care not described |
C Mod |
| Riegel 2006 USA |
6 mo
(2002-2004) |
69 |
65 |
72/42% |
NYHA III or IV: 82.6% LVEF%: 42.3% |
Nurse case manager contacts patient
5 days post-discharge. Software assists nurse in setting
priorities for the timing of the next telephone call, content
of patient education, and documentation. Nurse case manager
assesses poor adherence with meds and diet recommendations |
Usual care was not standardized,
and before discharge the nurse educated patients about heart
failure management typical discharge instructions included
medication list, institutional specific discharge instruction
sheet and hand written notes to follow a low sodium diet
and contact physician if symptoms occur |
A Wide |
| Stewart 1999 Australia |
6 mo
(1997-1998) |
100 |
100 |
75/62% |
NYHA III or IV: 88% LVEF mean%: 37% |
Multidisciplinary, home-based
intervention. Assessed by cardiac nurse 7-14 days after discharge.
Assessment of clinical status, understanding of disease and
psychological support. Counseling on strategies to improve
adherence where necessary |
Regular outpatient review by
the cardiologist |
A Wide |
| Stromberg 2003 Sweden |
12 mo
(1997-1999) |
52 |
54 |
77/63% |
NYHA III or IV:87% LVEF%: nd |
Patients scheduled for first
visit 2-3 weeks after discharge. 1 hr visit: nurse evaluated
status and optimized treatment; educated patient/family about:
heart failure and social support to the patient/ family,
dietary changes as restricted fluid, sodium and other self
care behaviors; monitor symptoms, weight gain and improve
patients self care regimen; Psychosocial support by creating
a supporting relationship between nurse and patient |
Usual care - managed with current
clinical practice and received conventional followup with
primary health care physician |
A Wide |
| Thompson 2005 England |
6 mo
(nd) |
58 |
48 |
73/72% |
NYHA: III/ IV 76% LVEF%: mean 31% |
A nurse led Clinic ( monthly
for 6 mo) plus home based intervention. Patients seen by
the study specialist nurses prior to discharge and received
a home visit within 10 days of hospital discharge; received
and educational packet, and a contact card |
Usual care patients received
standard care by explanation of their condition and prescribed
meds by the ward nurse and referral to appropriate post-discharge
support |
C Mod |
| Wierzchowiecki 2006 Poland |
12 mo
(nd) |
80 |
80 |
67/60% |
NYHA: III/IV 84% LVEF%:<45% n=66 (82.5%) |
At clinic: assessment by the
cardiologist; nurse assessment for medication compliance;
weight mgt; signs of CHF; telephone followup; home visits
as needed; QOL and self care questionnaires; eucational -
one to one education at patient's home or by telephone; physiotherapist's
assistance for exercise rehabilitation programme; psychologist's
assistance group and individual educational activities |
Routine care: cared by primary
care physicians only. Patient did not participate in any
educational or therapeutic activities of the program |
C Mod |
Table B3: Interventions on recruited
patients in OPD clinic
Study, Year
Country |
Followup
Duration
(Intervention y) |
No.
Analyzed |
|
Mean
/% |
Severity of
CHF |
Intervention components |
Control Description |
Quality
Applicability |
| Int |
Cont |
Age Male |
| Bouvy 2003 Netherlands |
6 mo
(1998-2000) |
74 |
78 |
69/72% |
NYHA: III/IV: 57% LVEF%: nd |
Community pharmacist-led intervention;
Pharmacist gave a structured interview to patient on initial
visit. Computerized medication history was used to discuss
drug use, reasons for non-compliance to reinforce medication
compliance. Pharmacist contacted subject monthly. + Usual
care. |
Patient received medication in
a medicine- container with a microchip that recorded the
time and date of opening |
B Wide |
| Gattis 1999 USA |
6 mo
(1996-1997) |
90 |
91 |
72/69% |
NYHA III or IV: 33% LVEF%: 30% |
Pharmacist led intervention and
followup: medication evaluation; therapeutic recommendations;
patient education on medication use and compliance; followup
telemonitoring |
Usual care: patient assessment
and education provided by the attending physician and/or
physician assistant or nurse practitioner |
A Mod |
| GESICA 2005 Argentina |
16 mo
(2000-2001) |
760 |
758 |
65/73% |
NYHA III or IV: 50% LVEF<40%: 78.6 |
Recruited from outpatient centers:
nurse led telephone followup program + Usual care: education,
counseling, and monitoring; adherence to the diet; adherence
to the drug treatment; monitoring of symptoms; control of
daily weight and edema; daily physical activity |
Usual care: followup with cardiologist |
A Mod |
| Murray 2007 USA |
12 mo
(2001-2004) |
122 |
192 |
62/39% |
NYHA: III/IV: 39% LVEF mean%: 49 |
Pharmacist led intervention to
improve medication adherence. Patients recruited from outpatient
clinics; pharmacists received training from multidisciplinary
team on treatment of heart failure, key concepts for pharmaceutical
care of older adults, communication techniques |
Usual care: patients received
prescription services from pharmacists who had not received
the specialized training and did not have patient centered
study materials |
C Mod |
| Sisk 2006 USA |
12 mo
(2000-2002) |
203 |
203 |
60/55% |
NYHA III or IV: 57.7% LVEF%: nd |
Patients recruited during a scheduled
clinic appnts; One nurse per patient: initial onetime appointment
to educate patient about disease, counsel self management,
referral to social services, review nurse's future role;
Referral to social services if needed; Telephone followup;
administering food frequency questionnaire; reinforce self
management; Coordinate patient care with patient's clinician |
Usual care - received federal
consumer guidelines for managing systolic dysfunction |
A Mod |
| Varma 1999 Northern Ireland |
12 mo
(nd) |
42 |
41 |
76/51% |
NYHA: nd LVEF%: nd |
Patients were recruited from both inpatient
admissions and outpatient clinic Results of a 2 minute walk
test were recorded. Body weight, blood pressure pulse and
forced vital capacity were measured. In clinic: Patients
received education from a pharmacist on the disease and its
treatment, and lifestyle changes that could help control
symptoms. Patients instructed on self monitoring, maintaining
daily weight in cards, instructed to take an extra dose of
diuretic if needed Only physicians and community pharmacists
were contacted to assess compliance. |
Standard management that excluded
all above mentioned interventions |
C Mod |
|
540 Gaither Road Rockville, MD 20850 