Improving Heart Failure Care in Minority Communities

This study has been completed.
Agency for Healthcare Research and Quality (AHRQ)
Information provided by:
Icahn School of Medicine at Mount Sinai Identifier:
First received: September 14, 2005
Last updated: NA
Last verified: September 2005
History: No changes posted

For congestive heart failure (CHF) patients with systolic dysfunction, a randomized controlled trial compared nurse-based disease management to address problems in patient and clinician management with usual care for effects on hospitalization and functioning among ethnically-diverse patients in ambulatory practices.

Condition Intervention
Congestive Heart Failure (CHF)
Systolic Dysfunction
Behavioral: Nurse-based disease management

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Educational/Counseling/Training
Official Title: Improving Heart Failure Care in Minority Communities

Resource links provided by NLM:

Further study details as provided by Icahn School of Medicine at Mount Sinai:

Primary Outcome Measures:
  • All-cause hospitalizations and self-reported physical functioning as measured by the physical component score on the Short Form 12 questionnaire and Minnesota Living with Heart Failure Questionnaire.

Secondary Outcome Measures:
  • Costs and cost-effectiveness

Estimated Enrollment: 406
Study Start Date: September 2000
Estimated Study Completion Date: October 2003
Detailed Description:

Congestive heart failure (CHF) disproportionately afflicts Black and elderly people, and is a leading cause of hospitalization > 65 years. Although effective therapies can improve functioning and survival in patients with systolic dysfunction, many may not be receiving the full benefit of existing knowledge, including counseling on self-management and appropriate doses of medications. Patients play a critical role in managing a chronic condition such as CHF, but may not have the skills to do so. Clinicians may not provide counseling or medications consistent with evidence-based guidelines.

Systematic reviews of clinical-behavior change have suggested that interventions targeted to specific problems are more likely to be successful. Based on shortfalls identified in patient self-management and clinical care in Harlem, a predominately non-white area in northern Manhattan, we tailored a nurse-management intervention to address the problems documented, and evaluated its effectiveness in a randomized controlled trial. This trial among primarily-minority patients addresses important gaps in this literature: the study targeted problems documented among CHF patients in Harlem, enrolled patients from ambulatory practices, randomly assigned patients between nurse-management and usual care, and evaluated their subsequent health-related outcomes. We hypothesized that the nurse-management program would result in nurse patients’ having fewer hospitalizations and reporting better functioning.


Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • • adults >18 years,

    • systolic dysfunction documented on a cardiac test (echocardiography, radionuclide ventriculography, myocardial stress sestamibi/thallium testing, or left-heart catherization),
    • English- or Spanish-speaking,
    • community-dwelling at enrollment, and
    • current patient in a general medicine, geriatrics, or cardiology clinic or office at a participating site.

Exclusion Criteria:

  • • medical conditions that prevented a patient’s interacting with the nurse, including blindness, deafness, and cognitive impairment;

    • medical conditions that required individualized management that might differ from standard protocol, namely pregnancy, renal dialysis, and terminal illness; and
    • procedures that corrected systolic dysfunction, such as heart transplantation.
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Please refer to this study by its identifier: NCT00211874

United States, New York
Harlem Hospital
New York, New York, United States, 10037
Metropolitan Hospital
New York, New York, United States, 10029
Mount Sinai School of Medicine
New York, New York, United States, 10029-6574
North General Hospital
New York, New York, United States, 10035
Sponsors and Collaborators
Icahn School of Medicine at Mount Sinai
Agency for Healthcare Research and Quality (AHRQ)
Principal Investigator: Jane Sisk, Ph.D. Icahn School of Medicine at Mount Sinai
  More Information

No publications provided Identifier: NCT00211874     History of Changes
Other Study ID Numbers: AHRQ R01 HS10402-01, 99-0347
Study First Received: September 14, 2005
Last Updated: September 14, 2005
Health Authority: United States: Institutional Review Board

Keywords provided by Icahn School of Medicine at Mount Sinai:
Congestive heart failure
nurse management
effectiveness trial
quality improvement
minority communities
disease management

Additional relevant MeSH terms:
Heart Failure
Cardiovascular Diseases
Heart Diseases processed this record on October 02, 2015