A heart failure self-management program for patients of all literacy levels: A randomized, controlled trial [ISRCTN11535170]
<p>Abstract</p> <p>Background</p> <p>Self-management programs for patients with heart failure can reduce hospitalizations and mortality. However, no programs have analyzed their usefulness for patients with low literacy. We compared the efficacy of a heart failure self-...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2006-03-01
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| Series: | BMC Health Services Research |
| Online Access: | http://www.biomedcentral.com/1472-6963/6/30 |
| _version_ | 1818792087308468224 |
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| author | Rothman Russell L Corr Kelly E Kosnar Margaret C Bryant Mary E Malone Robert M DeWalt Darren A Sueta Carla A Pignone Michael P |
| author_facet | Rothman Russell L Corr Kelly E Kosnar Margaret C Bryant Mary E Malone Robert M DeWalt Darren A Sueta Carla A Pignone Michael P |
| author_sort | Rothman Russell L |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Self-management programs for patients with heart failure can reduce hospitalizations and mortality. However, no programs have analyzed their usefulness for patients with low literacy. We compared the efficacy of a heart failure self-management program designed for patients with low literacy versus usual care.</p> <p>Methods</p> <p>We performed a 12-month randomized controlled trial. From November 2001 to April 2003, we enrolled participants aged 30–80, who had heart failure and took furosemide. Intervention patients received education on self-care emphasizing daily weight measurement, diuretic dose self-adjustment, and symptom recognition and response. Picture-based educational materials, a digital scale, and scheduled telephone follow-up were provided to reinforce adherence. Control patients received a generic heart failure brochure and usual care. Primary outcomes were combined hospitalization or death, and heart failure-related quality of life.</p> <p>Results</p> <p>123 patients (64 control, 59 intervention) participated; 41% had inadequate literacy. Patients in the intervention group had a lower rate of hospitalization or death (crude incidence rate ratio (IRR) = 0.69; CI 0.4, 1.2; adjusted IRR = 0.53; CI 0.32, 0.89). This difference was larger for patients with low literacy (IRR = 0.39; CI 0.16, 0.91) than for higher literacy (IRR = 0.56; CI 0.3, 1.04), but the interaction was not statistically significant. At 12 months, more patients in the intervention group reported monitoring weights daily (79% vs. 29%, p < 0.0001). After adjusting for baseline demographic and treatment differences, we found no difference in heart failure-related quality of life at 12 months (difference = -2; CI -5, +9).</p> <p>Conclusion</p> <p>A primary care-based heart failure self-management program designed for patients with low literacy reduces the risk of hospitalizations or death.</p> |
| first_indexed | 2024-12-18T15:21:40Z |
| format | Article |
| id | doaj.art-aced25b2d77e488eaba86af04ca53492 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-18T15:21:40Z |
| publishDate | 2006-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-aced25b2d77e488eaba86af04ca534922022-12-21T21:03:22ZengBMCBMC Health Services Research1472-69632006-03-01613010.1186/1472-6963-6-30A heart failure self-management program for patients of all literacy levels: A randomized, controlled trial [ISRCTN11535170]Rothman Russell LCorr Kelly EKosnar Margaret CBryant Mary EMalone Robert MDeWalt Darren ASueta Carla APignone Michael P<p>Abstract</p> <p>Background</p> <p>Self-management programs for patients with heart failure can reduce hospitalizations and mortality. However, no programs have analyzed their usefulness for patients with low literacy. We compared the efficacy of a heart failure self-management program designed for patients with low literacy versus usual care.</p> <p>Methods</p> <p>We performed a 12-month randomized controlled trial. From November 2001 to April 2003, we enrolled participants aged 30–80, who had heart failure and took furosemide. Intervention patients received education on self-care emphasizing daily weight measurement, diuretic dose self-adjustment, and symptom recognition and response. Picture-based educational materials, a digital scale, and scheduled telephone follow-up were provided to reinforce adherence. Control patients received a generic heart failure brochure and usual care. Primary outcomes were combined hospitalization or death, and heart failure-related quality of life.</p> <p>Results</p> <p>123 patients (64 control, 59 intervention) participated; 41% had inadequate literacy. Patients in the intervention group had a lower rate of hospitalization or death (crude incidence rate ratio (IRR) = 0.69; CI 0.4, 1.2; adjusted IRR = 0.53; CI 0.32, 0.89). This difference was larger for patients with low literacy (IRR = 0.39; CI 0.16, 0.91) than for higher literacy (IRR = 0.56; CI 0.3, 1.04), but the interaction was not statistically significant. At 12 months, more patients in the intervention group reported monitoring weights daily (79% vs. 29%, p < 0.0001). After adjusting for baseline demographic and treatment differences, we found no difference in heart failure-related quality of life at 12 months (difference = -2; CI -5, +9).</p> <p>Conclusion</p> <p>A primary care-based heart failure self-management program designed for patients with low literacy reduces the risk of hospitalizations or death.</p>http://www.biomedcentral.com/1472-6963/6/30 |
| spellingShingle | Rothman Russell L Corr Kelly E Kosnar Margaret C Bryant Mary E Malone Robert M DeWalt Darren A Sueta Carla A Pignone Michael P A heart failure self-management program for patients of all literacy levels: A randomized, controlled trial [ISRCTN11535170] BMC Health Services Research |
| title | A heart failure self-management program for patients of all literacy levels: A randomized, controlled trial [ISRCTN11535170] |
| title_full | A heart failure self-management program for patients of all literacy levels: A randomized, controlled trial [ISRCTN11535170] |
| title_fullStr | A heart failure self-management program for patients of all literacy levels: A randomized, controlled trial [ISRCTN11535170] |
| title_full_unstemmed | A heart failure self-management program for patients of all literacy levels: A randomized, controlled trial [ISRCTN11535170] |
| title_short | A heart failure self-management program for patients of all literacy levels: A randomized, controlled trial [ISRCTN11535170] |
| title_sort | heart failure self management program for patients of all literacy levels a randomized controlled trial isrctn11535170 |
| url | http://www.biomedcentral.com/1472-6963/6/30 |
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