Heart 1998;80:430-431 ( November )

Editorial

Nurse led, multidisciplinary intervention in chronic heart failure

The first 150 words of the full text of this article appear below.

Angiotensin converting enzyme (ACE) inhibitors reduce morbidity and mortality in chronic heart failure (CHF), however, the prognosis for patients with this disorder remains poor. In the treatment arm of the studies of left ventricular dysfunction (SOLVD) 35% of patients in the enalapril group died within the 3.5 years of follow up, 46% were admitted to hospital with worsening CHF, and 69% were admitted to hospital for any reason.¹ Digoxin may reduce the need for admission² but hospitalisation remains a frequent, distressing, costly, and recurring consequence of CHF.³

A number of investigators have attempted to identify potential precipitating and contributing factors to hospital admissions in patients with CHF.^4-11 The report by Michalsen et al is an important contribution to this serious and costly health issue.¹² Several common themes have emerged: limited understanding of the CHF state and its treatment is almost universal among patients; poor adherence to diet and pharmacological treatment is . . . [Full text of this article]

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