Effects of educational intervention on mortality and patient-reported outcomes in individuals with heart failure: A randomized controlled trial

Abstract

ObjectiveTo examine the effects of an educational intervention on patient-reported outcomes and all-cause mortality in heart failure (HF) patients MethodsIn this randomized controlled trial, we enrolled 122 hospitalized patients with HF. The intervention group (n = 60) received an individual nurse-led education session on HF self-management during hospitalization and three telephone calls after discharge. The control group (n = 62) received care as usual. Patient-reported outcomes were measured at baseline and at 3 and 6 months. Mortality status was determined using the National Death Records. Intervention effects were evaluated using the Cox proportional hazards regression model and linear mixed models. ResultsDuring the follow-up (median: 568 days), 7 deaths (12%) in the intervention group and 15 deaths (24%) in the control group occurred (adjusted hazard ratio, 0.40; 95% confidence interval, 0.16–0.98; P = .046). From baseline to 3 and 6 months, the intervention group showed greater improvements in HF knowledge (difference=6.14, P = .03; difference=5.76, P = .02, respectively), self-care (difference=−6.08, P < .001; difference=−6.16, P < .001, respectively), and health-related quality of life (difference=−11.90, P = .01; difference=−14.57, P = .004, respectively) than the control group. ConclusionEducational intervention with telephone follow-up reduced all-cause mortality and improved patient-reported outcomes. Practice implicationEducational intervention should be considered as part of routine care for HF patients.