Bridging the gap in heart failure prevention: rationale and design of the Nurse-led Intervention for Less Chronic Heart Failure (NIL-CHF) Study

TY - JOUR

T1 - Bridging the gap in heart failure prevention: rationale and design of the Nurse-led Intervention for Less Chronic Heart Failure (NIL-CHF) Study

AU - Carrington, Melinda J

AU - Stewart, Simon

AU - NIL-CHF Study Investigators

AU - de Courten, Barbora

PY - 2010/1/1

Y1 - 2010/1/1

N2 - AimsThe primary objective of the Nurse-led Intervention for Less Chronic Heart Failure (NIL-CHF) Study is to develop a programme of care that cost-effectively prevents the development of chronic heart failure (CHF).MethodsNIL-CHF is a randomized controlled trial of a hybrid, home-and clinic-based, nurse-led multidisciplinary intervention targeting hospitalized patients at risk of developing CHF. A target of 750 patients aged ≥45 years will be exposed to usual post-discharge care or the NIL-CHF intervention. The composite primary endpoint is all-cause mortality or CHF-related admission during 3-5 years of follow-up. After 12 months recruitment, ∼300 eligible patients (40 of target) have been randomized. Overall, 73 are male and the mean age is 65 ± 10 years. The most common antecedents for CHF thus far are hypertension (70, 95 CI, 64-75), coronary artery disease (51, 95 CI, 31-41), and type 2 diabetes (26, 95 CI, 21-31), whereas 76 (95 CI, 69-82) of patients have diastolic dysfunction, 29 (95 CI, 23-36) left ventricular hypertrophy, 71 (95 CI, 64-78) mitral valve dysfunction, and 7 (95 CI, 4-12) have a left ventricular ejection fraction ≤45.ConclusionAs one of the largest randomized studies of its kind, NIL-CHF will ultimately provide important insights into the potential to prevent CHF via prolonged and intensive disease management.

AB - AimsThe primary objective of the Nurse-led Intervention for Less Chronic Heart Failure (NIL-CHF) Study is to develop a programme of care that cost-effectively prevents the development of chronic heart failure (CHF).MethodsNIL-CHF is a randomized controlled trial of a hybrid, home-and clinic-based, nurse-led multidisciplinary intervention targeting hospitalized patients at risk of developing CHF. A target of 750 patients aged ≥45 years will be exposed to usual post-discharge care or the NIL-CHF intervention. The composite primary endpoint is all-cause mortality or CHF-related admission during 3-5 years of follow-up. After 12 months recruitment, ∼300 eligible patients (40 of target) have been randomized. Overall, 73 are male and the mean age is 65 ± 10 years. The most common antecedents for CHF thus far are hypertension (70, 95 CI, 64-75), coronary artery disease (51, 95 CI, 31-41), and type 2 diabetes (26, 95 CI, 21-31), whereas 76 (95 CI, 69-82) of patients have diastolic dysfunction, 29 (95 CI, 23-36) left ventricular hypertrophy, 71 (95 CI, 64-78) mitral valve dysfunction, and 7 (95 CI, 4-12) have a left ventricular ejection fraction ≤45.ConclusionAs one of the largest randomized studies of its kind, NIL-CHF will ultimately provide important insights into the potential to prevent CHF via prolonged and intensive disease management.

KW - Aged

KW - Chronic Disease

KW - Clinical Protocols

KW - Female

KW - Follow-Up Studies

KW - Heart Failure

KW - Humans

KW - Male

KW - Middle Aged

KW - Nurse's Practice Patterns

KW - Patient Care Team

KW - Practice Guidelines as Topic

KW - Research Design

KW - Survival Analysis

U2 - 10.1093/eurjhf/hfp161

DO - 10.1093/eurjhf/hfp161

M3 - Journal article

C2 - 19926594

SN - 1567-4215

VL - 12

SP - 82

EP - 88

JO - European Journal of Heart Failure, Supplement

JF - European Journal of Heart Failure, Supplement

IS - 1

ER -