Effectiveness of an educational self‐management program for outpatients with chronic heart failure

Abstract

Aim: The occurrence rate of chronic heart failure (CHF) in Japan is estimated to be 50 000 per one million persons. It is important for the Japanese medical financial system to institute a program of disease management in order to prevent the deterioration of persons with CHF. However, there are still few studies on the disease management of CHF in Japan. Therefore, the purpose of this study was to provide an educational self-management program to Japanese outpatients with CHF in order to improve their clinical outcomes. Methods: A randomized, controlled trial with 102 outpatients with CHF was conducted. There were 50 participants in the intervention group and 52 participants in the control group. The control group received medical treatment and standard care. In addition to this, the intervention group also received an educational program for 6 months. The program consisted of six nurse-directed sessions that were provided to each outpatient once per month in a clinical setting for a total of 6 months. A follow-up session was conducted each month for 6 months. The data collection was carried out at the start of the program and at 3, 6, 9, and 12 months. Results: Significant differences could be observed in the primary and secondary outcomes and in the process indicators between the two groups after the program began. In other words, all the indicators improved for the intervention group, compared to the control group. Therefore, this program was considered to be effective. Conclusion: Further long-term care is necessary for outpatients with CHF in order to prevent their deterioration and to maintain their health status, even though this 6 month program did provide them with proper knowledge regarding self-care for CHF and affected their therapy results.

36-Month Follow-Up Study of Post-Intervention Chronic Heart Failure Patients

“…Repeated two-way analysis of variance was performed on physiological, QOL, and compliance data [9]. The Wilcoxon rank-sum test was also conducted to compare time variations in each group to see if the results from repeated two-way analysis of variance showed significant difference in physiological, QOL, and compliance data.…”

“…The period of the educational program was set for 6 months because a minimum of 6 months was required for patients to acquire self-management skills [14] and the program was carried out for 30 minutes once a month individually with a total 6 sessions conducted with a pamphlet developed on the basis of evidence-based clinical guidelines [9]. After that, follow-up, which consisted of confirmation by interview of whether the intervention group continued to implement self-management and discussion of directions to achieve personal goal setting if their self-management was not continued appropriately, were conducted for an average of 20 minutes once a month for 6 months and the disease management program including a follow-up period which was carried out for a total of 12 months.…”

“…The first follow-up period 7 to 12 months after the educational program started was from March 20 to October 31, 2008 [9]. The second follow-up research 24 months after the program started was conducted from August 20 to October 31, 2009 [11].…”

“…The program, developed by Otsu and Moriyama [9], was carried out for the intervention group. The control group received standardized treatment and care that was provided as general treatment and care according to the conditions of the individual at a medical facility.…”

“…However, it is necessary to research further long-term effects of disease management programs for CHF because it has not yet been revealed how long effects will last. The purpose of this study is to conduct follow-up investigations of these effects up to 36 months after program commencement in Otsu and Moriyama [9].…”