A nurse-led collaborative care model integrated with mobile health significantly improves overall survival and increases days spent out of the hospital for patients with heart failure with reduced ejection fraction (HFrEF), according to findings from the TIME-HF trial presented at ESC Congress and simultaneously published in Circulation. Researchers state the model could serve as a vital blueprint for nations facing restricted healthcare access.
TIME-HF Trial Design and Patient Demographics
The trial randomized approximately 1,500 patients with HFrEF across 22 centers in India to either a nurse-led intervention program or usual care, following participants for up to two years. According to study data, the mean age of participants was 62 years, with roughly 78% identifying as men. Furthermore, 70% of participants had limited education, and 57% lived in rural settings, while all but one participant completed the full 24 months of follow-up.
The nurse-led disease management program combined mobile health integration with self-care education, active follow-up, and continuous outpatient monitoring throughout the study duration. This structured framework targeted gaps in guideline-directed medical therapy adherence, particularly in regions where specialist resources remain scarce.
Did you know? Approximately 57% of the participants in the TIME-HF trial lived in rural areas, demonstrating that mobile health and nurse-led interventions can successfully reach geographically isolated heart failure populations.
Clinical Outcomes and Survival Rates
Overall results demonstrated a significantly higher probability of surviving without hospitalization among patients in the intervention group compared to those receiving usual care, at 84.0% versus 79.4% respectively, with a p-value below the threshold of statistical significance. Investigators tracked both survival metrics and the total duration patients avoided inpatient hospital admissions.
“Taken together, the data suggest that a structured, nurse-coordinated, technology-enabled delivery model may offer a practical strategy to improve heart failure outcomes in routine care,” said Panniyammakal Jeemon, MD, in presenting the findings. “We believe this model is not only relevant to low- and middle-income countries but also to other settings around the world where adherence to guideline-directed medical therapies is suboptimal.”
Expert Perspectives on Team-Based Cardiovascular Care
In a related editorial comment, Rajeev Gupta, MD, PhD, noted that improving adherence to medications and healthy lifestyles is a critical area of investigation in heart failure care. Gupta added that this study focusing on transitional care represents one of the largest trials with the longest follow-up duration conducted in South Asia.
Kitko, PhD, RN, emphasized the trial’s significance for team-based care models. Kitko wrote that TIME-HF advances heart failure implementation science by linking a nurse-coordinated collaborative care intervention directly to changes in evidence-based prescribing and subsequent clinical outcomes for patients with HFrEF. Kitko also noted that the broader contribution lies in demonstrating that nurses, when supported by digital tools and collaborative authority, can function as the core implementation infrastructure for high-value cardiovascular care.
Frequently Asked Questions
What was the primary goal of the TIME-HF trial?
The trial evaluated whether a nurse-led collaborative care model integrated with mobile health could improve overall survival and increase days out of the hospital for patients with heart failure with reduced ejection fraction.
How many patients participated in the study?
The trial randomized approximately 1,500 patients with HFrEF across 22 medical centers in India and followed them for up to two years.
What specific interventions did the nurse-led program include?
The program incorporated self-care education, active patient follow-up, continuous outpatient monitoring, and mobile health tools throughout the duration of the study.
Where were the trial results published?
The findings were presented at ESC Congress and simultaneously published in the journal Circulation.
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