Feasibility of a nurse-monitored, outpatient-care programme for elderly patients with moderate-to-severe, chronic heart failure.
OBJECTIVE
To evaluate the feasibility of a nurse-monitored, outpatient-care program for elderly patients previously hospitalized with chronic heart failure.


RESULTS
Patients with chronic heart failure hospitalized in the medical wards were screened to find those eligible for a randomized study to compare the effect of a nurse-monitored, outpatient-care programme aiming at symptom management, with conventional care. The inclusion criteria were patients classified in New York Heart Association classes III-IV, age 65 years, and eligibility for an outpatient follow-up programme. The total in-hospital population of patients discharged with a heart-failure diagnosis was surveyed. Eighty-nine per cent of all the hospitalized patients (n=1541) were 65 years old. Of these, 69% (n=1058) were treated in the medical wards which were screened. The study criteria were met by 158 patients (15%). No visits to the nurse occurred in 23 cases among the 79 patients randomized to the structured-care group (29%), mainly on account of death or fatigue. The numbers of hospitalizations and hospital days did not differ between the structured-care and the usual-care groups.


CONCLUSIONS
Given the selection criteria and the outline of the interventions, the outpatient, nurse-monitored, symptom-management programme was not feasible for the majority of these elderly patients with moderate-to-severe, chronic heart failure, mainly because of the small proportion of eligible patients and the high drop-out rate. Management of these patients would have to be more adjusted to their home situation.
Ekman
I
I
Department of Nursing, Umeå University, Sweden.
Andersson
B
B
Ehnfors
M
M
Matejka
G
G
Persson
B
B
Fagerberg
B
B
D000368:Aged; D000553:Ambulatory Care / Q000458:organization & administration*; D003266:Continuity of Patient Care; D005240:Feasibility Studies; D005260:Female; D006333:Heart Failure / Q000145:classification / Q000628:therapy*; D006757:Hospital Units; D006785:Hospitals, University; D006801:Humans; D008297:Male; D018670:Monitoring, Ambulatory; D009732:Nursing Care / Q000458:organization & administration*; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D015397:Program Evaluation; D013548:Sweden