Nurse-Led Intervention Boosts Cardiac Rehab: Study

Almost 90% adhered to fluid restriction, weigh-ins when aided by trained support group

MONDAY, Nov. 5, 2007 (HealthDay News) -- Intensive support from a heart failure nurse and a multidisciplinary team improves the likelihood that heart failure patients will comply with crucial non-medical interventions, such as salt and fluid restrictions and regular weighing, says a study by Dutch researchers.

"We examined the effect of education and counseling by heart failure nurses on adherence to nonpharmacologic treatments, because these are so important to the patients' survival," lead author Martje H.L. van der Wal, a cardiology nurse researcher at the University of Groningen, said in a prepared statement.

The 18-month study looked at 1,023 heart failure patients, average age 71, treated at 17 hospitals. The patients were divided into three groups:

  • The first (control) group received usual care, which included regular visits to their cardiologist.
  • The second group (basic support) received basic education and counseling from a specialized heart failure nurse. These patients visited the nurse every three months at the heart failure clinic and could call the nurse with questions if their heart failure worsened.
  • The third group (intensive support) received intensive counseling and education from a heart failure nurse and had contact with the nurse at least once a month, including one or more home visits. These patients also received advice from a dietician, social worker and physiotherapist.

During the study:

  • 90 percent of patients in the support groups adhered to their fluid restriction, compared to 67 percent before the start of the study. There was no change in the control group.
  • 90 percent of patients in the support groups adhered to heart failure diet restrictions, compared to 75 percent before the start of the study.
  • 89 percent of patients in the intensive support group and 79 percent of patients in the basic support group weighed themselves regularly, compared with 56 percent of patients in the control group.

The researchers also found that more patients in the support groups were aware of important symptoms of worsening heart failure and when to call health-care providers.

"Support from a heart failure nurse can help patients to cope with the difficult and complex regimen they have for their heart failure and to incorporate the regimen into their daily lives," van der Wal said.

The study was to be presented Monday at the American Heart Association annual meeting in Orlando, Fla.

More information

The U.S. National Heart, Lung, and Blood Institute has more about heart failure.

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