Nurse-coordinated collaborative care improved outcomes in patients with heart failure
Days alive and out of hospital were significantly increased in patients with heart failure when a nurse-coordinated collaborative care model was introduced, according to results presented in a Hot Line session at ESC Congress 2026 and published simultaneously in Circulation.
A nurse-led collaborative care model significantly improved outcomes for patients with heart failure, according to a study presented at ESC Congress 2026 and published in Circulation. Heart failure, affecting over 64 million people worldwide, poses a major public health challenge characterized by high mortality, morbidity, and healthcare costs.
While medical therapies are available to reduce deaths and hospitalizations, their utilization in real-world practice remains suboptimal, contributing to persistent global disparities in heart failure outcomes. Dr. Panniyammakal Jeemon from Sree Chitra Tirunal Institute for Medical Sciences & Technology in India designed the TIME-HF trial, a cluster-randomized trial involving 1,507 adults with heart failure and reduced ejection fraction across 22 centers in India.
The trial compared a nurse-coordinated collaborative care model to usual care. The nurse-led intervention involved trained nurses working closely with physicians to deliver integrated, patient-centered care, utilizing a mobile health application for real-time communication, data collection, and patient self-monitoring. Nurses provided structured counseling on lifestyle changes, medication adherence, and self-care education.
The study found that guideline-directed medical therapy use was higher in the intervention group (37.3% at two years) compared to the usual-care group (22.1% at two years). Importantly, the intervention group experienced a 22% reduction in mortality (84.0% vs 79.4%) and a higher probability of surviving without hospitalization (84.0% vs 79.4%) at two years (p<0.001).
This suggests that a structured, nurse-coordinated, technology-enabled delivery model may effectively improve heart failure outcomes in routine care, a strategy applicable to both low- and middle-income countries and other settings worldwide where adherence to guideline-directed medical therapies is lacking.
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