Impact of a Hybrid Nurse-Led Home and Clinic-based Intervention on Hospitalization and Related Hospital Stay: Results From a Pragmatic, Randomized Trial (the NIL-CHF Study)

Background: Beyond pharmacological treatment, there is a paucity of data to support the application of disease management programs that bridge (predominantly short-term) cardiac rehabilitation and chronic heart failure (CHF) management programs. Methods: The NIL-CHF Study was a pragmatic randomized trial that tested the hypothesis that relative to Standard Care a nurse-led, multidisciplinary management program for hospitalized patients aged ≥ 45 years with pre-existing CVD and/or common antecedents of CHF, will reduce the incidence of admission for CHF or all-cause mortality (primary endpoint) and secondary endpoints of rehospitalization and recurrent hospital stay (specific focus on emergency and cardiovascular-related events) during mean 4.3 years follow-up. Results: A total of 611 subjects (mean age 66±11 years and 71% male) without baseline CHF (echocardiography confirmation), of whom 70% had an acute coronary syndrome and 62% were hypertensive, were randomized to Standard Care (n=310) or NIL-CHF inte...