8.2.2 Assessing the impact of the BHF and BIG heart failure nursing service in England (221)

Jill Pattenden, Senior Research Fellow, Health Sciences, University of York, Heslington, United Kingdom Co authors: Simon Coulton & Karen Spilsbury jp30@york.ac.uk

Abstract:

Heart failure affects about 2% of the population with an annual incidence of 0.5-1%. Treatment takes up about 1.8% of the NHS budget, 5% of acute admissions, and 10% of bed occupancy.1 Regular monitoring of this patient group by heart failure nurses has been shown to improve quality of life, reduce readmissions and mortality and be cost effective2, 3 In recognition of this, in 2004 the BHF with the Big Lottery Fund provided funding for the employment of 76 community heart failure specialist nurses in 26 Primary Care Trusts. Clinical and demographic data has been collected over two year on 9,350 patients in the nurses’ caseloads. Data on hospital readmissions over a one year period have been compared to hospital episode statistics. The evidence suggests that patients seen by heart failure specialist nurses are readmitted on fewer occasions for fewer nights. But these nurses incur a cost over and above the cost of routine provision of heart failure services, so we are currently carrying out a cost benefit analysis of the service. Results will be presented at the conference. 752 of these patients and 342 carers have completed a battery of health related quality of life measures, with follow up at 12 months exceeding the estimated 70% response rate with 86% and 85% respectively. The final sample exceeds the numbers required in the power calculation. Baseline data showed that the mean age of patients is 72. Self-care scores were low, quality of life poor, and 83% of the sample had borderline anxiety disorder. Follow up data is currently being analysed and will be presented at the conference. Systematic reviews as to the effectiveness of heart failure specialist nurses have mostly included studies outside the UK. This is a large pragmatic study to assess the impact of these nurses in England.

Biography:

Jill Pattenden Research Fellow, British Heart Foundation Care and Education Research Group Jp30@york.ac.uk Jill Pattenden is a senior research fellow in the Department of Health Sciences at the University of York. Jill has managed a range of research and evaluation projects exploring health service innovation, and health promotion and public health interventions to promote behaviour change. Jill has experience of teaching on a number of formal academic courses at both undergraduate and postgraduate level. Jill has carried out a study of the decision making processes in people with symptoms of heart attack, and carried out a systematic review of the effectiveness of interventions based on a stages of change approach to promote individual behaviour change. More recently her main area of interest is in research of interventions aiming improve the lives of people with heart failure. Current research involves evaluating the BHF heart failure specialist nurse service, an RCT of a menu-based, nurse-facilitated self-management programme for patients with heart failure, and evaluating an end of life initiative for patients with heart failure and their families.