Effectiveness of Nurse-Coordinated, Digital-Supported Collaborative Care Model in Reducing Hospital Stay and Mortality Among Patients With Heart Failure: TIME-HF Cluster RCT (India).

A nurse-coordinated, mobile health-supported collaborative care model for heart failure with reduced ejection fraction in India increased days alive and out of hospital, with 46.5% probability at 730 days.

• Why it matters: Heart failure with reduced ejection fraction in India leads to high mortality and recurrent hospitalizations, creating a need for care models that improve time out of hospital and survival.
• What they did: In a parallel-group cluster-randomized controlled trial of 1507 adults across 22 centers, centers were assigned 1:1 to the intervention or usual care, with 2-year follow-up. The intervention used risk stratification, lifestyle and pharmacological optimization, and nurse-coordinated mobile health disease management with continuous outpatient monitoring.
• The result: Compared with usual care, the intervention increased the probability of surviving to 730 days without hospitalization from 34.7% to 46.5% and reduced all-cause mortality from 26.73% to 21.59% (hazard ratio 0.78; P=0.028).