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Bridging the gap in heart failure prevention: Rationale and design of the Nurse-led intervention for Less Chronic Heart Failure (NiL-CHF) Study
Carrington, Melinda J. Stewart, Simon
Carrington, Melinda J.
Stewart, Simon
Abstract
Aims
The 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). Methods
NIL-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%. Conclusion
As 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.
Keywords
Chronic heart failure, Prevention, Disease management, Hypertension
Date
2010
Type
Journal article
Journal
European Journal of Heart Failure
Book
Volume
12
Issue
1
Page Range
82-88
Article Number
ACU Department
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled