Self-Care Interventions That Reduce Hospital Readmissions in Patients With Heart Failure; Towards the Identification of Change Agents

Abstract

Unplanned hospital readmissions are the most important, preventable cost in heart failure (HF) health economics. Current professional guidelines recommend that patient self-care is an important means by which to reduce this burden. Patients with HF should be engaged in their care such as by detecting, monitoring, and managing their symptoms. A variety of educational and behavioural interventions have been designed and implemented by health care providers to encourage and support patient self-care. Meta-analyses support the use of self-care interventions to improve patient self-care and reduce hospital readmissions; however, efficacy is variable. The aim of this review was to explore methods to achieve greater clarity and consistency in the development and reporting of self-care interventions to enable ‘change agents’ to be identified. We conclude that advancement in this field requires more explicit integration and reporting on the behaviour change theories that inform the design of self-care interventions and the selection of behaviour change techniques. The systematic application of validated checklists, such as the Theory Coding Scheme and the CALO-RE taxonomy, will improve the systematic testing and refinement of interventions to enable ‘change agent/s’ to be identified and optimised.

The roles of health literacy and social support in improving adherence to self‐care behaviours among older adults with heart failure

“…In Korea, the prevalence of HF is expected to increase twofold, from 1.60% in 2015 to 3.35% in 2040 (Kim et al., 2017). Despite effective medical interventions, mortality and morbidity remain high, particularly among those aged 65 years and older (Toukhsati, Jaarsma, Babu, Driscoll, & Hare, 2019). HF constitutes an enormous economic burden for healthcare systems globally (Kessing et al, 2017; Toukhsati et al., 2019).…”

“…Despite effective medical interventions, mortality and morbidity remain high, particularly among those aged 65 years and older (Toukhsati, Jaarsma, Babu, Driscoll, & Hare, 2019). HF constitutes an enormous economic burden for healthcare systems globally (Kessing et al, 2017; Toukhsati et al., 2019). Optimal self‐care behaviours are vital to reduce adverse health outcomes among older patients with HF (Herber, Atkn, Stork, & Wilm, 2018).…”

“…Effective self‐care, including symptom monitoring, regular exercise, sodium restriction and weight control, is a key component of HF management to improve the patient's prognosis (Herber et al, 2018; Jankowska‐Polanska et al., 2020). Recent studies have reported that self‐care behaviours can improve the health status and quality of life of patients with HF and reduce readmission and mortality rates (Beckie, Campbell, Schneider, & Macario, 2017; Lei & Cai, 2018; Toukhsati et al., 2019). Unfortunately, patients with HF feel that self‐care is difficult because of the multiple requirements of treatment regimens, such as polypharmacy and lifestyle adjustments for multimorbid conditions (Jankowska‐Polanska et al, 2020; Uchmanowicz, Jankowska‐Polańska, Mazur, & Froelicher, 2017).…”

Effectiveness of Mobile Phone-Based Interventions for Improving Health Outcomes in Patients with Chronic Heart Failure: A Systematic Review and Meta-Analysis

“…However, previous studies have reported low adherence rates in self-care behaviors, due to the complexity of self-care and lifelong requirement of medical treatment [9,10]. Thus, many studies have evaluated various types of interventions to improve HF self-care behaviors and associated outcomes [11][12][13].…”

Toma de decisiones para el manejo de los síntomas de falla cardíaca: protocolo de intervención

“…Los resultados del estudio son comparables con los hallazgos de ECA que han examinado las intervenciones para mejorar el autocuidado en los adultos con FC (27)(28)(29)(30)(31)(32)(33)(34)(35). No fue posible analizar los resultados teniendo en cuenta la dosis y el contenido educativo por falta de datos.…”