Failure of self-managment couseling in heart failure patients

Researchers at Rush University Medical Center, in Chicago tell us, “Motivating patients with heart failure to adhere to medical advice has not translated into clinical benefit.”

They think past studies were flawed. So, in this study, they studied the value of self-management counseling + heart failure education, compared with heart failure education alone.

First, the details.

• 902 patients with mild to moderate heart failure were offered 18 contacts and 18 heart failure educational tip sheets over 1 year.
• The patients were randomly assigned to a treatment group.
  • Education group received tip sheets in the mail and telephone calls to check their comprehension.
  • Self-management group received tip sheets in groups and were taught self-management skills to implement the advice.
• Death and hospitalization for heart failure over 2.5 years were recorded.

And, the results.

• Patients were similar to typical clinical populations (average age, 64 years; 47% women; 40% racial/ethnic minority; 52% with annual family income less than $30,000).
• There were no significant differences in death, heart failure hospitalization, hospitalization for any reason, or quality of life.
• And, there were no differences between groups on change in heart or respiratory rate, blood pressure, or body mass index.

The bottom line?

The authors concluded, “Compared with an enhanced educational intervention alone, the addition of self-management counseling did not reduce death or heart failure hospitalization in patients with mild to moderate heart failure.”

The prognosis for patients with heart failure is poor. In 2002, the risk of dying with heart failure was 28% — more than 3 times higher than for age- and sex-matched patients without heart disease.

It’s estimated that 2.4 million adults in the US have heart failure. So, beyond what the medical sytem can provide, there’s a need for patients to be more self-reliant regarding their healthcare in order to improve their lives and decrease their risk of dying due to a heart disease complication.

One option to meet this goal might be Internet, as described in this successful study of patients with fibromyalgia.

9/26/10 22:07 JR