TIME-HF
Team based collaborative care model, facilitated by mHealth enabled and trained nurses, for management of heart failure with reduced ejection fraction in India (TIME-HF)
In 1,507 patients with HFrEF at 22 hospitals in India, nurse-led, app-supported collaborative care increased days alive and out of hospital over 2 years compared with usual care.
Nothing new was prescribed here: a trained nurse, a phone app and structured counselling raised four-pillar therapy from 22% to 37% and bought days out of hospital and fewer deaths — the gap between what the guidelines say and what patients receive is itself treatable. Cluster-randomised and open-label, so the difference includes the attention the intervention arm received, and 22 units mean the unit of randomisation is small. Read as a health-services finding for a setting where 57% of patients live rurally; whether the same nurse-and-app package moves anything where baseline adherence is already high is a different trial.