Association of Risk‐Stratified WeChat ‐Based Tele‐Nursing With Self‐Care Outcomes and Short‐Term Readmission Among Patients With Chronic Heart Failure: A Retrospective Cohort Study

ABSTRACT

Chronic heart failure (CHF) is frequently complicated by post‐discharge readmission. This study evaluated structured risk‐stratified WeChat‐based tele‐nursing in routine post‐discharge care. This retrospective cohort study included 112 patients with CHF hospitalized during 2023–2024; 58 received tele‐nursing and 54 routine follow‐up. Propensity score matching (PSM) was performed. The primary outcome was 6‐month heart failure‐related readmission. Six‐month readmission occurred in 13.8% versus 31.5% in the unmatched cohort ( p  = 0.02) and 15.2% versus 32.6% after 1:1 PSM (46 pairs; p  = 0.04). The unmatched adjusted Cox estimate was HR 0.43 (95% CI 0.18–0.99), whereas the matched Cox estimate was HR 0.45 (95% CI 0.18–1.08); penalized, complete‐case, and Fine‐Gray sensitivity analyses were also not statistically significant. The exploratory 12‐month HR was 0.55 (95% CI 0.30–1.02; n  = 94). All three SCHFI v7.2‐C subscales improved more with tele‐nursing (all p  < 0.001). Tele‐nursing was associated with greater improvement in patient‐reported self‐care and a possible association with lower short‐term readmission, which requires prospective confirmation.