Evidence to practice: pre-post-implementation study of a patient/provider resource for self-management with heart failure

Abstract

Background Evidence-based recommendations for heart failure self-management are contained in quality clinical practice guidelines. To implement these in practice requires additional translation. Partners in Care for Congestive Heart Failure (PCCHF) is a set of resource materials developed to encourage heart failure patients and their families to assume greater responsibility and to participate in daily decision-making related to their illness experience by enhancing their self-assessment and self-management skills. The study objectives were to evaluate its use, acceptability and relevance of this approach by heart failure patients, nurses and policy-makers. Methods A pre-post study was conducted across 10 rural-urban, acute and community care sites within three Canadian provinces and one US state. Patients' health-related quality of life was assessed with Minnesota Living with Heart Failure Questionnaire and Medical Outcomes Short Form before and 6 weeks after using the PCCHF program. Nurses completed a survey and participated in focus groups. Policy-makers were interviewed before and post implementation. Results Baseline and 6-week measures were completed by 239 patients. Health-related quality of life measures revealed statistically significant improvement after 6 weeks. Thirty-three nurses and 19 policy-makers participated in interviews post implementation. Most patients, nurses and policy-makers found the resource acceptable and relevant to support information needs. Conclusion The PCCHF program positively benefited both patients and clinical staff. The evidence-based teaching materials were considered a useful resource for self-management with heart failure. Time constraints and high staff turnover underline the need for resources like PCCHF to assist in patient-oriented heart failure self-management. Copyright for PCCHF has been transferred to the Canadian Heart and Stroke Foundation for widespread dissemination.