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Background Hospital admissions among patients with congestive heart failure (CHF) are a major contributor to health-care costs. Previous investigations suggest that the therapeutic efficacy of pharmacotherapy in CHF may be improved by strategies incorporating home visits to identify and address factors precipitating deterioration and resultant readmission. Methods Chronic CHF patients discharged home after acute hospital admission were randomly assigned usual care (n= 100) or a multidisciplinary, home-based intervention (n= 100), consisting of a home visit by a cardiac nurse 7–14 days after discharge. The primary endpoint of the study was frequency of unplanned readmission plus out-of-hospital death within 6 months. Findings During 6 months' follow-up there were 129 primary endpoint events in the usual-care group and 77 in the intervention group (p= 0· 02). More intervention-group than usual-care …