Abstract
Objectives. We tested both an educational and a care coordination element of health care to examine if better disease-specific knowledge leads to successful self-management of heart failure (HF). Background. The high utilization of health care resources and poor patient outcomes associated with HF justify tests of change to improve self-management of HF.Methods.This prospective study tested two components of the Chronic Care Model (clinical information systems and self-management support) to improve outcomes in the self-management of HF among patients who received intensive education and care coordination during their acute care stay. A postdischarge follow-up phone call assessed their knowledge of HF self-management compared to usual care patients. Results. There were 20 patients each in the intervention and usual care groups. Intervention patients were more likely to have a scale at home, write down their weight, and practice new or different health behaviors. Conclusion. Patients receiving more intensive education knewmore about their disease and were better able to self-manage their weight compared to patients receiving standard care.
Highlights
Heart failure is a chronic disease resulting from multiple diseases of the heart such as coronary artery disease [1]
Heart failure is the most common principal discharge diagnosis among Medicare beneficiaries and half of the heart failure (HF) patients above 65 years old are readmitted within 6 months of hospital discharge [4]
Of these 131 patients, 35 patients refused to participate in the study and 39 did not meet inclusion/exclusion criteria, leaving 57 patients that were enrolled and signed a consent form
Summary
Heart failure is a chronic disease resulting from multiple diseases of the heart such as coronary artery disease [1]. According to the American Heart Association (AHA), nearly 5.7 million people in the United States currently have heart failure (HF) [2]. Heart failure is the most common principal discharge diagnosis among Medicare beneficiaries and half of the HF patients above 65 years old are readmitted within 6 months of hospital discharge [4]. Within the Veterans Health Administration (VHA) heart failure is a high cost disease. The VHA saw nearly 6 million unique veterans in 2011; 50% were 65 years or older and 9% were female. 2007, 424 Veterans had a diagnosis of heart failure (ICD-9 428) and 20% of HF patients had an all-cause readmission within 30 days of discharge
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