A nurse-led collaborative care model that integrated mobile health improved overall survival and days out of the hospital among patients with heart failure with reduced ejection fraction (HFrEF) in India, based on findings from the TIME-HF trial presented at ESC Congress 2026 and simultaneously published in Circulation. Researchers highlight that this model may serve as a blueprint for other countries where access to care is limited.
The trial randomized approximately 1,500 patients with HFrEF across 22 centers in India to either the nurse-led intervention program or usual care and followed them for up to two years. The nurse-led disease management program integrated mobile health and included self-care education, active follow-up, and continuous outpatient monitoring throughout the study period. The mean age of participants was 62 years, roughly 78% were men, 70% had limited education, 57% lived in rural areas, and all but one completed 24 months of follow-up.
Overall findings showed a significantly higher probability of surviving without hospitalization with the intervention vs. usual care (84.0% vs. 79.4%; p<0.001). Additionally, there was a 22% reduction in deaths at two years with the nurse-led intervention compared with usual care.
“Taken together, the data suggest that a structured, nurse-coordinated, technology-enabled delivery model may offer a practical strategy to improve heart failure outcomes in routine care,” said Panniyammakal Jeemon, MD, in presenting the findings. “We believe this model is not only relevant to low- and middle-income countries but also to other settings around the world where adherence to guideline-directed medical therapies is suboptimal.”
In a related editorial comment, Rajeev Gupta, MD, PhD, notes that “improving adherence to medications and healthy lifestyles is an important area of investigation in HF, and this study focused on transitional care for HF is one of the largest with the longest follow-up from South Asia.”
In another editorial comment, Lisa A. Kitko, PhD, RN, highlights the importance of the trial to team-based care, writing, “TIME-HF advances the science of heart failure implementation by connecting a nurse-coordinated collaborative care intervention with changes in evidence-based prescribing and subsequent clinical outcomes in patients with [HFrEF]. Its broader contribution may be the demonstration that nurses, supported by digital tools and collaborative authority, can serve as the implementation infrastructure for high-value cardiovascular care.”
Visit ACC’s ESC Congress 2026 coverage page to explore the latest science and key takeaways shaping cardiovascular care.
Keywords:
ESC Congress, ESC26