BMJ  2005;331:425 (20 August), doi:10.1136/bmj.38516.398067.E0 (published 1 August 2005)

Paper

Randomised trial of telephone intervention in chronic heart failure: DIAL trial

¹ Fundación GESICA, Av Rivadavia 2358, PB4, C1034ACP, Buenos Aires, Argentina

Objective To determine whether a centralised telephone intervention reduces the incidence of death or admission for worsening heart failure in outpatients with chronic heart failure.

Design Multicentre randomised controlled trial.

Setting 51 centres in Argentina (public and private hospitals and ambulatory settings).

Participants 1518 outpatients with stable chronic heart failure and optimal drug treatment randomised, stratified by attending cardiologist, to telephone intervention or usual care.

Intervention Education, counselling, and monitoring by nurses through frequent telephone follow-up in addition to usual care, delivered from a single centre.

Main outcome measure All cause mortality or admission to hospital for worsening heart failure.

Results Complete follow-up was available in 99.5% of patients. The 758 patients in the usual care group were more likely to be admitted for worsening heart failure or to die (235 events, 31%) than the 760 patients who received the telephone intervention (200 events, 26.3%) (relative risk reduction = 20%, 95% confidence interval 3 to 34, P = 0.026). This benefit was mostly due to a significant reduction in admissions for heart failure (relative risk reduction = 29%, P = 0.005). Mortality was similar in both groups. At the end of the study the intervention group had a better quality of life than the usual care group (mean total score on Minnesota living with heart failure questionnaire 30.6 v 35, P = 0.001).

Conclusions This simple, centralised heart failure programme was effective in reducing the primary end point through a significant reduction in admissions to hospital for heart failure.

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Rapid Responses:

Read all Rapid Responses

Close the clinics and cancel home visits in heart failure management? What do the results of the DIAL Trial really tell us?

Robyn Clark, et al.
bmj.com, 23 Aug 2005 [Full text]

Fantastic for heart failure…. but how does it work?

Dr Gerard J Molloy
bmj.com, 19 Aug 2005 [Full text]

Are calculations correct ?

murad ruf, et al.
bmj.com, 21 Aug 2005 [Full text]

What is the DIAL trial?

Tsung O. Cheng
bmj.com, 30 Aug 2005 [Full text]

Re: Are calculations correct ?

Daniel C Ferrante, et al.
bmj.com, 11 Oct 2005 [Full text]

Re: What is the DIAL trial?

Hugo O Grancelli, et al.
bmj.com, 11 Oct 2005 [Full text]

Re: Close the clinics and cancel home visits in heart failure management? What do the results of the DIAL Trial really tell us?

Hugo O Grancelli, et al.
bmj.com, 19 Oct 2005 [Full text]

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