Home-based nurse-led self-management support for heart failure: a randomized controlled trial

To evaluate the effect of a nurse-led, stage-tailored home-based self-management and follow-up programme on self-care behaviour in people with heart failure.

People with heart failure require ongoing education, symptom monitoring, and self-management support after specialist assessment. However, access to structured centre-based cardiac rehabilitation may be limited. A nurse-led home-based model may help bridge the gap between specialist cardiology care and community-based long-term support, particularly where rehabilitation services are unavailable.

In this parallel-group randomized controlled trial, adults aged 40-75 years with New York Heart Association class I-III heart failure and ejection fraction >30% were allocated to a 12-week home-based programme or usual care. The intervention was delivered through nurse-led home visits and telephone follow-up for clinically stable patients who could not access structured centre-based rehabilitation. The intervention group received home visits and telephone follow-up (n = 32), while the control group received usual care (n = 31). The primary outcome was self-care behaviour. Secondary outcomes were quality of life, self-efficacy, and physical capacity. Exploratory clinical outcomes were body composition, ejection fraction, and HbA1c level.