Effectiveness of a nurse practitioner-led collaborative health care model on self-care, functional status, rehospitalization and medical costs in heart failure patients: A randomized controlled trial

Background: Heart failure is a serious and common condition that has garnered significant attention in the global public health domain. It often results in impaired function and reduced cardiac function status, leading to difficulties in self-care and diminished quality of life. To effectively address these complex challenges, the collaborative health care model has been proposed. This approach has proven effective in reducing rehospitalization and lowering medical costs.

Objective: To evaluate the effects of a nurse practitioner-led collaborative health care model on the self-care, functional status, rehospitalization and medical costs of patients with heart failure.

Design: A randomized controlled trial design.

Setting: Cardiology department of a regional teaching hospital in Southern Taiwan.

Participants: 100 patients diagnosed with heart failure.

Methods: Patients diagnosed with heart failure were recruited through random allocation and. randomly assigned to two groups. The control group included 50 patients who received routine nursing guidance; the experimental group also included 50 patients who participated in a 12-week collaborative health care program. Key outcomes, including self-care, functional status, rehospitalization, and medical costs, which were evaluated at 12, 16, and 20 weeks post-discharge.

Results: The intervention of the collaborative healthcare program significantly impacted self-care, functional status, rehospitalization, and medical costs. Significant improvements in self-care and functional status were observed at 20 weeks (Self-Care: β = 31.52, 95 % CI: 25.96 to 37.07, p < 0.001; Functional Status: χ² = 22.42, p < 0.001). Regarding rehospitalization, the average rehospitalization duration for the experimental group significantly increased compared to 1.45 months for the control group, with the experimental group averaging 3.00 months at the 20-week follow-up. Moreover, the experimental group also demonstrated a reduction in rehospitalization medical costs, particularly with significant effects observed in the early stages of intervention (β = -6147.94, 95 % CI: -10,763.99 to -1531.88, p = 0.009).

Conclusion: The use of a nurse practitioner-led collaborative health care model significantly improved self-care, function status and reduced rehospitalization while effectively lowering medical costs for patients with heart failure. Through professional team communication and collaboration, this approach provides more effective and comprehensive care, enhances patient self-management capabilities, and improves overall treatment outcomes. These results hold significant implications for clinical practice and provide empirical support for future heart failure care programs, warranting their widespread implementation in clinical settings.

Registration: This study was registered on ClinicalTrials.gov under the identifier NCT04860596 on April 22, 2021, and participant recruitment was initiated in April 2023.

Tweetable abstract: Effectiveness of a Nurse Practitioner-Led Collaborative Care Model: Reduces rehospitalization and medical costs, while improving self-care and functional status in heart failure patients. A Randomized Controlled Trial. #HeartFailure #HealthCare #SelfCare.