Abstract 11737: Heart Failure Patients Who Have Knowledge About Their Disease but Don’t Perform Self-Care Have Worse Clinical Outcomes

Abstract

Introduction: Both knowledge and self-care are related to outcomes of heart failure (HF) patients. Some HF patients do not perform self-care even if they have knowledge about the disease and might be in need for special interventions. We aimed at describing characteristics of those patients and assessing their clinical outcomes. Methods: A total of 163 HF outpatients were enrolled (age 64, 70% male, NYHA I or II, 95%) and followed for 2 years. HF self-care risk score was calculated by counting the number of poor adherence to five self-care behaviors (medication, a low-sodium diet, exercise, daily weighing, and help-seeking behavior) (range, 0-6). Knowledge was assessed with a Japanese HF knowledge scale (range, 0-15). Subsequently, we classified patients into 4 groups (A-D) as shown in figure. We analyzed patient’s characteristics in group C (poor self-care but good knowledge) by ANOVA and Chi-square test. To assess clinical outcomes we used Kaplan-Meier method and Cox regression analysis. Results: The mean HF self-care risk score was 3.1±1.6 and the mean knowledge score was 10.9±2.9. In total, 45 patients (28%) were classified into Group C [76% male, mean B-type natriuretic peptide (BNP) levels, 164 pg/mL]. Compared with other groups, patients in Group C were likely to be younger (61±13 vs. 65±11 years, p=0.059). Their self-care scores did not correlate with their knowledge scores (p=0.99). During a 2-year follow-up period, 29 patients (18%) had HF hospitalization and/or cardiac death, with a significant higher rate in Group C (30%, Fig, p=0.04). After adjustment for age, BNP, and medical therapy, patients in Group C had 2.8 times higher risk of poor outcomes than other groups (hazard ratio=2.80, p=0.01). Conclusions: One-third of patients have HF knowledge but they do not perform self-care, and they have worse outcomes compared with other groups. Further study is necessary to examine those patients in more detail and to provide support for them to put knowledge into action.