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Study: Heart patients helped by phone calls

Counseling calls cut 29 percent of hospital visits

By Debra Goldschmidt
CNN Medical Unit

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CHICAGO (CNN) -- Phone calls from nurses to people at home with congestive heart failure can reduce hospitalizations by 29 percent, according to a new study, and could go a long way toward lowering medical costs for patients.

Dr. Daniel Nul, who presented the findings of the study at a briefing held at the annual Scientific Sessions of the American Heart Association, said phone intervention also leads to a smaller -- 5 percent -- reduction in mortality.

But, Nul said, the cost of this intervention is lower than the cost of patients being hospitalized, a significant point because much of the cost associated with congestive heart failure stems from patients needing to be hospitalized after they suffer setbacks.

The study, performed in Argentina, followed more than 1,500 patients with congestive heart failure for approximately 15 months to determine whether phone intervention reduced mortality and hospitalizations from heart failure.

In the study, a test group of 760 patients received regular phone calls. A control group of 758 did not receive regular phone calls. Instead, the patients received regular follow-up for congestive heart failure, such as appointments with their doctor, and calls every three months to verify their status in the study and to check for such events as unreported hospitalizations.

The patients receiving telephone intervention were called by trained nurses, who asked about the patient's symptoms, medications, and changes in weight, diet and physical activity.

The nurses were able to change doses of medications and recommend doctor visits. They also counseled patients on nutrition.

Throughout the study, three nurses made more than 17,000 calls from one calling center. Each nurse called the same patients. Nul said that allowed the nurse and patient to get to know each other.

According to the American Heart Association, 4.8 million Americans have congestive heart failure, which occurs when a damaged heart is unable to pump out all of the blood that returns to it. As a result, blood backs up in the veins leading to the heart, and fluid can accumulate in various parts of the body.

Patients with heart failure are told to follow strict diets because salty foods worsen the condition. Heart-failure patients also follow a strict medication regimen.

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