The majority of our
patients only visited the nurse-led clinic once.
Obviously one visit can make a difference and our
results confirm results reported by Stewart and
co-workers.16 Since we did not have a clear longterm
effect on reduced hospital admissions, there
might be a need for a standardised visit to the heart
failure clinic 3–6 months after the initial visit for all
patients. However, it is not certain this would have
an effect. Stewart and co-workers showed that the
effect of the single visit was retained over a period
of 18 months without repeated visits.13 Cline and
co-workers had a visit at 8 months, but only showed
a trend toward fewer readmissions and days in
hospital.25 All studies performed in this field have
included quite a small number of patients. It would
be valuable to conduct a larger, randomised, multicentre
trial. Today it is difficult to conduct this
type of trial in Sweden, since the concept with
nurse-led heart failure clinics is an established
model for follow-up after hospitalisation in the
majority of the county and university hospitals in
Sweden.