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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

There is no doubt that heart failure is a major and costly health care issue. In this context, the study by Riegel et al¹ is interesting. However, several weaknesses in the study and interpretation of the results mean that the findings have uncertain practical relevance in the management of heart failure.

First, there is a lack of detail on the precise activities or interventions of the nurses. Examples are mentioned in the "Patients and Methods" section, but it is all very hazy. Second, and related to the previous point, what intermediary factors were responsible for the improved outcomes? For instance, did the program result in improved prescribing of heart failure drugs, improved patient compliance with medication, or perhaps improved lifestyle management (diet and exercise)?

Third, it appears that patients in the intervention group were being treated more appropriately for heart failure than the control group patients at the study baseline. . . . [Full Text of this Article]

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