Nursing telephone follow-up and outcomes in heart failure patients: a retrospective observational study
Accepted: 13 May 2025
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Introduction: Heart Failure (HF) is associated with high rates of rehospitalization and mortality. Nursing telephone follow-up is rec- ognized as effective in ensuring adequate continuity of care and reducing post-discharge complications.
Objective: to evaluate the impact of a nurse-led telephone follow-up program on reducing hospital readmissions and mortality at 6 and 12 months after hospital discharge for HF.
Materials and Methods: the retrospective observational cohort study was conducted at the Cardiology outpatient clinic of a spoke hospital in northeastern Italy. Two groups of patients with heart failure (HF) were compared, one of which underwent telephone fol- low-up.
Results: in the first 6 months, the group without follow-up had an average of 0.56 hospital readmissions compared to 0.2 in the fol- low-up group (P=0.004). Six-month mortality was 20% in the group without follow-up and 4% in the follow-up group (P=0.014). Between 7 and 12 months, differences in readmissions and mortality were not statistically significant.
Conclusions: telephone follow-up conducted by trained nursing staff, aimed at comprehensive care including symptom monitoring and nursing coaching, during the 6 months following hospitalization for acute HF has a significantly positive impact on the number of hospital readmissions and mortality.
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