HEART failure care delivered through a nurse-coordinated collaborative model significantly improved survival without hospitalisation and reduced mortality in patients with heart failure with reduced ejection fraction, according to findings from the TIME-HF trial presented during the European Society of Cardiology (ESC) Congress 2026.
The study evaluated whether a nurse-led intervention supported by mobile health technology could improve uptake of guideline-directed medical therapies and clinical outcomes in routine clinical practice.
The cluster-randomised trial included 1,507 adults with heart failure with reduced ejection fraction across 22 centres in India.
Centres were randomly assigned to either a nurse-coordinated collaborative care model or ‘usual care’.
Patients in the intervention group received integrated support from trained nurses working closely with physicians.
The model incorporated a mobile health application that enabled communication, monitoring, and collection of patient data.
Patients could record warning signs and symptoms, while nurses provided counselling on lifestyle modification, medication adherence, self-care strategies, and behaviour change.
Those in the usual care group continued to receive standard management from their treating physicians.
The mean age of participants was 62 years, 32% were women, and 57% lived in rural areas.
The study’s author reported consistently higher use of guideline-directed medical therapies among patients receiving the intervention.
At 2 years, adherence to all four recommended therapies was 37.3% in the intervention group compared with 22.1% in the usual care group.
The study’s primary endpoint was days alive and out of hospital, selected as a patient centred measure of benefit.
Analysis showed that the probability of surviving for up to 2 years without hospitalisation was significantly higher among patients receiving nurse-coordinated care (84.0% versus 79.4% for the ‘usual care’ group).
The intervention was also associated with a significant reduction in mortality. At 2 years, deaths were reduced by 22% in the intervention group compared with usual care.
The study’s author suggested that combining early treatment optimisation with sustained nurse-led follow up may help address persistent gaps between guideline recommendations and real-world heart failure care.
These findings indicate that a structured, technology enabled collaborative care approach may offer a practical method to improve heart failure outcomes and increase uptake of guideline-directed medical therapies.
The model may have relevance not only in low- and middle-income countries, but also in healthcare settings where adherence to recommended heart failure treatments remains suboptimal.
Kitko LA. Advancing the science of nurse-led collaborative care in heart failure. Circulation. 2026;DOI:10.1161/CIRCULATIONAHA.126.082775.
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