[Nurse-managed clinic provides a good foundation for heart failure patients].
We report one of the first analyses of modern heart failure treatment in clinical practice, using beta-blockers and ACE-inhibitors, based on computerised evaluation of a nurse-administered outpatient clinic. One hundred thirty-three patients were treated. Up-titration of an ACE-inhibitor was performed in 104 patients, 13% of whom had to discontinue treatment due to intolerance. Beta-blockers were introduced in 42 patients, and 2% had to discontinue. Of those continuing therapy 97% and 89% of the targeted dose was reached, ACE-inhibitors and beta-blockers, respectively. During the titration 52% of the patients receiving an ACE-inhibitor, and 57% of those receiving a beta-blocker, reported symptomatic improvement. In contrast to pharmaceutical studies, our patients were referred with no other selection than that applied by the patient's physician. With a nurse-monitored treatment strategy it was possible to achieve a high rate of treatment compliance with ACE-inhibitors and beta-blockers.
Andersson
Bert
B
Sahlgrenska Universitetssjukhuset, Göteborg. bert.andersson@hjl.gu.se
Brunlöf
Gertrud
G
Lundberg
Per-Arne
PA
Lindstedt
Göran
G
D000318:Adrenergic beta-Agonists / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000451:nursing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009718:Nurse Administrators; D024802:Nurse's Role; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration* / Q000592:standards; D010347:Patient Care Planning; D010349:Patient Compliance; D018579:Patient Selection; D013548:Sweden
D000318:Adrenergic beta-Agonists; D000806:Angiotensin-Converting Enzyme Inhibitors