Objective: To assess the effectiveness of a nurse specialist in managing patients with heart failure in the community.
Design: Out patient attendances and re-admissions to hospital for the two years (April 1995-97) before the service started were compared with the two years afterwards (April 1997-99).
Setting: Integrated Community and Acute Trust in West Lothian.
Patient population: Sixty one patients with severe heart failure (New York Heart Association class IV).
Results: Twenty eight patients died within the study period. Of those surviving, total re-admissions (bed days used) were reduced from 605 to 270 days, outpatient clinic attendances fell from 168 to 60. Among those who died the rates corrected for survival period were not changed for re-admission but reduced from a mean of 6.6 to 2.3 attendances per patient.
Conclusion: A nurse lead service for patients with heart failure significantly reduces clinic attendances and hospital re-admission.