Effectiveness of an Educational Intervention With Home Visits and Telephone Follow-Up on Knowledge and Quality of Life in Patients With Heart Failure: A Randomized Clinical Trial.

Only 101 of 120 randomized patients completed the 60-day follow-up, and losses included deaths and clinical deterioration, so the results apply mainly to patients who remained in the study. The trial measured knowledge and quality of life, not hospital readmission or death, even though the sample size was originally planned for a combined readmission and death outcome. The intervention combined nurse-led home visits, telephone calls, an educational booklet, a self-care recording tool, and physical examinations, so the effect of any single component cannot be separated. The control group also received in-person assessments, a telephone contact at 30 days, and a readmission recording form, and got the booklet after the final evaluation, so this was not a comparison with no follow-up. Patients with NYHA class IV, cognitive impairment, no telephone access, major sensory or mobility limitations, or residence more than 50 km from a hospital were excluded, so findings may not apply to those groups. Baseline education was imbalanced, with more illiterate or lower-education patients in the control group, and the authors say this may have influenced baseline differences. Follow-up was short at 60 days, and the study did not compare home visits alone or telephone follow-up alone with the combined strategy.

The authors report nothing to disclose, and no funding source is stated.

Do not conclude that this programme reduces heart failure readmission or death. The trial measured knowledge and quality of life, and the home visits, telephone calls, booklet, and self-care tool were given together, so their separate effects cannot be identified.