[Nurse-managed clinic provides a good foundation for heart failure patients]

We report one of the first analyses of modern heart failure treatment in clinical practice, using beta-blockers and ACE-inhibitors, based on computerised evaluation of a nurse-administered outpatient clinic. One hundred thirty-three patients were treated. Up-titration of an ACE-inhibitor was performed in 104 patients, 13% of whom had to discontinue treatment due to intolerance. Beta-blockers were introduced in 42 patients, and 2% had to discontinue. Of those continuing therapy 97% and 89% of the targeted dose was reached, ACE-inhibitors and beta-blockers, respectively. During the titration 52% of the patients receiving an ACE-inhibitor, and 57% of those receiving a beta-blocker, reported symptomatic improvement. In contrast to pharmaceutical studies, our patients were referred with no other selection than that applied by the patient's physician. With a nurse-monitored treatment strategy it was possible to achieve a high rate of treatment compliance with ACE-inhibitors and beta-blockers.