Effectiveness of nurse-led heart failure clinic: A systematic review.
Xiaoxiao Wu, Zhen Li, Qingxiu Tian and 2 others
PMID 39156682WHAT IT FOUND
Nurse-led heart failure clinics were associated with fewer heart failure admissions and better medication dose optimisation in several studies.
Evidence on quality of life and cost savings remained unclear.
Key findings
01Four included studies found reduced heart failure admission rates, including a 27% reduction in a primary-care implementation study.
02In a randomised nurse-led titration clinic, patients reached the maximum beta-blocker dose in 90 days on average, compared with 166 days in the control group.
03Quality of life improved in some included studies, while others found no significant between-group difference.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review did not combine studies in a meta-analysis because outcome measures varied widely. Many included studies were pre-post or observational, so changes over time or other services may have affected results. Clinic content varied widely, including education, medication titration, monitoring, and psychosocial support. Only English-language studies were included. Few studies measured cost-effectiveness. Some studies did not report patient numbers or outcome details.
Declared interests
The work was supported by National High Level Hospital Clinical Research Funding. The authors declared no conflict of interest.
The easy way to misread this
Do not conclude that nurse-led heart failure clinics improve quality of life or save money. Quality of life results were mixed, and cost-effectiveness evidence was limited.