Follow‐up study for a disease management program for chronic heart failure 24 months after program commencement

Abstract

Aim: There are few studies dealing with comprehensive chronic heart failure (CHF) disease management programs, which are based on self-management, in Japan. We developed and conducted a comprehensive educational program for CHF for 6 months that aimed to improve self-management and prevent the deterioration of outpatients with CHF. Our follow-up research focused on whether performance of selfmanagement in the intervention group continued for 24 months after commencement. Methods: Participants were selected from patients who went for follow-up visits to one Japanese clinic, which specialized in cardiovascular internal medicine, that were diagnosed with CHF. During the first follow-up period, 7 to 12 months after program commencement, 47 participants in the intervention group and 47 participants in the control group were analyzed. During the second follow-up period, 13 to 24 months after program commencement, 41 participants in the intervention group were analyzed. Results: Participants in the intervention group acquired self-management skills and activities and these continued up to 24 months after the program commencement. As a result, no deterioration in symptoms related to CHF was demonstrated. Meanwhile, quitting smoking and drinking depended on individual preference and it was difficult to improve. Conclusions: The educational program was effective in the long term and the program is significant for use in busy medical situations that do not offer sufficient follow-up support for patients. Regular intervention and ways that produce longer-lasting effects should be further developed.

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

“…Otsu and Moriyama [11] did a 24-month long-term follow-up study after starting their disease management program which was the longest follow-up period among previous studies and the results confirmed that performance of self-management of activities and self-monitoring of weight was continuous and no participants deteriorated. Consequently, long-lasting effects were proven in the 24 months after program commencement in [11].…”

“…They used the RAND 36-item Health Survey and the Kansas City Cardiomyopathy Questionnaire as the scale of QOL, and it was reported that there was no significant difference at 6 and 12 months in the follow-up period. Very few previous studies examined the long-term effects [11]. Hence, our study showed precious data because we collected long-term data up to 36 months after program commencement.…”

“…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 third follow-up research 36 months after the program started was conducted from August 20 to October 31, 2010.…”

“…Consequently, long-lasting effects were proven in the 24 months after program commencement in [11]. 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.…”

“…Although numerous studies of disease management and CHF case management programs have been carried out, only a few studies examined the long-term effects of disease management and case management programs [6] [11]. Medical factors such as ischemic heart disease and abnormal cardiac rhythm were pointed out as factors in the deterioration of CHF [12].…”