Abstract 14607: Discharge Education Based on Teach-Back Method Improves Outcomes in Patients With Heart Failure

Abstract

Introduction: Heart failure (HF) is one of the most common causes of hospital readmission. Self-care is essential but challenging task in patients with HF, and self-care deficit is closely related to unplanned readmission and unnecessary health expenditure. Patient centered education using teach-back method (TBM) emerged as a key strategy to prevent patients’ adverse events by improving self-care. This study aims to evaluate the effects of TBM in patients with HF. Hypothesis: HEART program ® , a TBM-based discharge education, will significantly improve self-care, symptom experience, caregiver dependency, and unplanned healthcare utilization. Methods: This was a randomized controlled trial in HF patients with left ventricular ejection fraction ≤50%. Before discharge, the experimental group (EG) received HEART program ® by a trained nurse, while the control group (CG) received usual discharge education. Measures were self-care (self-care maintenance; symptom-perception; self-care management), symptom experience, caregiver dependency at 7-days after discharge, and healthcare utilization (readmission; emergency room visit; hospital contact, etc.) at 1-month after discharge. Outcomes were analyzed with ANCOVA and Chi-squared test using SPSS program 25. Results: A total of 86 patients (EG = 40, CG = 46) completed the study (mean age 61±12 years; mean left ventricular ejection fraction 30±9%; mean duration of illness 4 years; mean hospitalization day 8±7). Self-care (self-care maintenance, F =12.3; symptom perception, F =15.4; self-care management, F =6.0) in the EG significantly improved compared with the CG (all P s<.01). On the other hand, there were no significant differences in symptom experience and caregiver dependency between the two groups (all P s>.05). For healthcare utilization, only hospital contact via telephone was significantly different between the EG and CG (N=1 vs. 8; P =.032). Conclusions: This result indicates that discharge education based on TBM is an effective strategy to improve self-care ability, which could lead to reducing unplanned health expenditure in patients with HF. We suggest that healthcare providers implement TBM education for patients with chronic HF.