Phoned-in nursing care does nothing to prevent re-hospitalization of people recuperating from heart failure, says a study by researchers at the Stanford University School of Medicine.

The study tested the effectiveness of nurse care management, a widely used system of telephone-based health instruction and follow-up designed to help patients manage their illnesses.

The researchers studied 462 patients receiving treatment for clinically low-risk heart failure at five Kaiser Permanente hospitals in the San Francisco Bay area.

Half of the participants received nurse care management, with Stanford nurses phoning them 16 times during the yearlong study to instruct them about their condition and check that they were taking the appropriate medications. All participants received the usual follow-up care provided by their own doctor.

"The idea is that if you give patients information on how to manage their illness, they will do it," said lead researcher Dr. Robert F. DeBusk, a professor of cardiovascular medicine at Stanford.

But half of the patients were re-hospitalized whether they received nurse care management or not. Most re-hospitalizations were for treatment of coronary artery disease, while one-third were for treatment of heart failure.

These findings are at odds with past studies that showed substantial benefits to specialized care management. The Stanford researchers suggest the benefits may vary depending on the severity of illness and the quality of comprehensive health care.

"Nurse care management holds tremendous promise for patients at higher risk or those not receiving comprehensive care, but that doesn't mean it's universally effective," DeBusk said.

The findings appear in the Oct. 19 issue of the Annals of Internal Medicine.

More information

The American Heart Association has more about heart failure.

Reference Source 101
October 19, 2004

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