Impact of Nurse-Led, Multidisciplinary Home-Based Intervention on Event-Free Survival Across the Spectrum of Chronic Heart Disease

There is an increasing pressure to develop cost-effective strategies to mitigate persistently high levels of rehospitalization and premature mortality associated with chronic heart disease. Beyond pharmacological agents and devices, disease management programs are integral to applying flexible, guideline-based management, coordinating care, and providing individualized support. However, the evidence to support their application across the full spectrum of heart disease remains incomplete and fragmented. For example, although the overall evidence supporting short-term cardiac rehabilitation and chronic heart failure (CHF) management programs is extensive and mostly favorable, there is a paucity of research to support programs designed to prevent progressive cardiac dysfunction in patients who survive an acute coronary syndrome or to optimize outcomes in those with atrial fibrillation (AF). Moreover, a diverse range of disease management techniques have been tested. Ideally, the same form of disease management program adapted to the individual patient profile would be tested across a diverse range of cardiac patients receiving high levels of standard care to determine its overall potential to improve health outcomes in the real-world setting.