Effect of a Standardized Nurse Case-Management Telephone Intervention on Resource Use in Patients With Chronic Heart Failure

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Abstract
HEART FAILURE (HF) is an extremely common disorder and one that is associated with significant morbidity, mortality, and cost.1-3 Because of this burden, investigators are actively exploring ways to improve the outcomes associated with HF. Pharmaceutical therapy reduces hospitalization from 12%4 to 35%,5 depending on the agent. Higher rates are found when a combined end point of mortality and rehospitalization is used.6,7 In comparison, in randomized trials of comprehensive disease management, hospital admission rates were reduced from 27%8 to 73%,9 with most interventions demonstrating reductions in the 40% to 50% range.10 Disease management approaches shown to be effective include multidisciplinary disease management,11 heart failure clinics,12 and community outreach programs.13 Telephonic case management is another approach believed to promote continuity of care and decrease hospitalization rates in persons with HF. However, few clinical trials have tested the effectiveness of this approach,14-16 and only 1 study was conducted among patients with HF.14

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