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Cardiac clinics provide better care

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Nurse-led disease management programmes for the secondary prevention of cardiovascular events are both effective and economic, a large study has concluded.

Over 12 months, researchers studied over 1,000 patients with coronary heart disease and chronic heart failure in 20 primary care practices across the UK.

Half the patients received usual GP and practice nurse care. The other half received usual care plus intervention from a heart failure nurse specialist at a weekly clinic, which included patient assessment and medication management.

The researchers also carried out an economic analysis to determine the effect the nurse-led programme had on costs.

The authors said that, although overall costs in the intervention group were higher than that of the control group – for example more patients had their condition confirmed with echocardiography – the quality of life was significantly improved for patients in the intervention group.

They added that extra costs incurred by the programme from prescribing medications such as statins were offset by the fact that patients in the intervention group had significantly improved cholesterol levels compared with those in the control group.

‘Even in the short term, these disease management programmes may represent a cost-effective service, as additional quality-of-life years are generated at an acceptable cost,’ the authors said online in the journal Heart.

Amanda Crundall, heart failure nurse specialist at Doncaster PCT, said: ‘It goes without saying that costs are increased with intervention from a heart failure nurse specialist, because treatment and tests are instigated and maximised, which do cost money.’

She added: ‘But this only highlights that there are several thousand patients who are not adequately treated and investigated.

‘Part of the heart failure nurse specialist’s role is to shed light on how poorly heart failure patients are managed without specialist intervention.’

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