Follow-up programs can reduce chronic heart failure deaths
A new Cochrane systematic review finds that chronic heart failure patients who are contacted in active follow-up programs after leaving hospital are less likely to have died a year after discharge than those given standard care. Patients in such programs are also less likely to be readmitted in the 6 months following discharge.

Researchers examined 25 clinical trials of nearly 6000 patients that re­viewed different methods of organizing the care of chronic heart failure patients after they leave hospital. The types of care examined were:

•    Case management interventions, where patients were intensively moni­tored by phone calls and home visits (usually by a specialist nurse).
•    Clinic interventions involving follow-up in a specialist chronic heart failure clinic.
•    Multidisciplinary interventions, in which a team of professionals bridg­ed the gap between hospital admission and living back at home. 

The data examined showed that pa­tients who received case-management intervention had less all-cause mortality a year after discharge than those receiving usual care.

For more information visit www.thecochranelibrary.com [8].

Inhaled pain relief in early labor safe and effective
Cochrane researchers have determined inhaled pain relief to be safe and effective in the early stages of labor. Data for the review were compiled from 26 studies involving a total of 2959 women. The review found that while nitrous oxide provided effective pain relief, women should be warned that it can cause side effects like nausea, vomiting, dizziness, and drowsiness. Fluranes, which can only be administered under supervision of an analgesia professional, provide a more powerful effect than nitrous oxide, and have fewer side effects.

Recognizing that some of the trials reviewed involved small numbers of women, the authors call for more trials to be conducted involving larger numbers of women, looking at which forms of anesthetic give women a greater sense of control in labor, satisfaction with the childbirth experience, and ease in moving on to breastfeeding.  

For more information visit www.thecochranelibrary.com [8].