In 2005, Penny H. Feldman with her group of researchers assigned randomly (The randomization was carried out by staff blinded to the study) individuals newly diagnosed with heart failure into three groups of home care nurses; one group delivered usual care (the control group), the second and third (intervention groups) delivered basic and augmented care. The latter two nurses groups received email reminders about heart failure guidelines. In addition, the nurses in the augmented group received a laminated card of medication management, a prompter card, and a self-care guide for patients, and a follow-up by a nurse specialist. This toolset was sent each time whenever a new patient was assigned to them.

Individuals with heart failure were interviewed 45 days after the intervention with several validated questionnaires to assess the quality of life, heart failure specific outcomes. They found that both interventions improved heart failure specific mean scores significantly, 40.4 in the control group versus 46.5 and 45.6 in the basic and augmented groups respectively (P<0.05). The interventions had a positive effect on weight monitoring, medication knowledge, and diet. Moreover, they found that the basic intervention was more cost-effective than the augmented one.  However, the researchers noted that the level of nonadherence among patients assigned to the augmented group was substantial. This shows that more improvements are needed.

This study raised a very interesting question too. Contrary to anyone’s expectation, the intervention group patients did not experience the lower use of medical care services than the control group. They discuss several possible explanations for this observation: heightened awareness leading to seeking more medical services, shorter duration to see the optimum benefit of the intervention, and absence of involvement of a physician who is authorised to adjust medication doses.

My takeaway message: Email reminders to practising nurses are a cost-effective and useful way to translate research findings into practice although it might improve only consumers’ knowledge component and some behavioural changes such as weight monitoring and diet. However, I believe the reminders should adhere to message framing theories that I discuss in this blog.

Anyone who is  interested in the topic can access to this paper here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361172/