Lynda H. Powell|James E. Calvin|DeJuran Richardson|?mke Janssen|Carlos F. Mendes de Leon|Kristin J. Flynn|Kathleen L. Grady|Cheryl Rucker?Whitaker|Claudia Eaton|Elizabeth Avery
Self-management Counseling in Patients With Heart Failure
Rush University Medical Center
h3contexth3motivating patients heart failure adhere medical advice translated clinical benefit past trials methodological limitationsh3objectiveh3to determine value selfmanagement counseling plus heart failure education compared heart failure education alone primary end point death heart failure hospitalizationh3design setting patientsh3the heart failure adherence retention trial hart singlecenter multiplehospital partially blinded behavioral efficacy randomized controlled trial involving 902 patients mild moderate heart failure reduced preserved systolic function randomized chicago metropolitan area october 2001 october 2004 undergoing followup 2 3 subsequent yearsh3interventionsh3all patients offered 18 contacts 18 heart failure educational tip sheets course 1 year patients randomized education group received tip sheets mail telephone calls check comprehension patients randomized selfmanagement group received tip sheets groups taught selfmanagement skills implement adviceh3main outcome measureh3death heart failure hospitalization median 256 years followuph3resultsh3patients representative typical clinical populations mean age 636 years 47 women 40 racialethnic minority 52 annual family income less 30 000 23 preserved systolic function rate primary end point selfmanagement group different education group 163 401 vs 171 412 respectively odds ratio 095 95 confidence interval 072126 significant differences secondary end points including death heart failure hospitalization allcause hospitalization quality lifeh3conclusionsh3compared enhanced educational intervention alone addition selfmanagement counseling reduce death heart failure hospitalization patients mild moderate heart failureh3trial registrationh3clinicaltrialsgov identifier nct00018005