Darren A. DeWalt|Robert M. Malone|Mary E Bryant|Margaret C. Kosnar|Kelly E. Corr|Russell L. Rothman|Carla A. Sueta|Michael Pignone
A heart failure self-management program for patients of all literacy levels: A randomized, controlled trial [ISRCTN11535170]
University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|Vanderbilt University Medical Center|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill
selfmanagement programs patients heart failure reduce hospitalizations mortality however programs analyzed usefulness patients low literacy compared efficacy heart failure selfmanagement program designed patients low literacy versus usual carewe performed 12month randomized controlled trial november 2001 april 2003 enrolled participants aged 3080 heart failure took furosemide intervention patients received education selfcare emphasizing daily weight measurement diuretic dose selfadjustment symptom recognition response picturebased educational materials digital scale scheduled telephone followup provided reinforce adherence control patients received generic heart failure brochure usual care primary outcomes combined hospitalization death heart failurerelated quality life123 patients 64 control 59 intervention participated 41 inadequate literacy patients intervention group lower rate hospitalization death crude incidence rate ratio irr 069 ci 04 12 adjusted irr 053 ci 032 089 difference larger patients low literacy irr 039 ci 016 091 higher literacy irr 056 ci 03 104 interaction statistically significant 12 months patients intervention group reported monitoring weights daily 79 vs 29 p 00001 adjusting baseline demographic treatment differences found difference heart failurerelated quality life 12 months difference 2 ci 5 9a primary carebased heart failure selfmanagement program designed patients low literacy reduces risk hospitalizations death