Document Detail


Self-management counseling in patients with heart failure: the heart failure adherence and retention randomized behavioral trial.
MedLine Citation:
PMID:  20858878     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Motivating patients with heart failure to adhere to medical advice has not translated into clinical benefit, but past trials have had methodological limitations. OBJECTIVE: To determine the value of self-management counseling plus heart failure education, compared with heart failure education alone, for the primary end point of death or heart failure hospitalization. DESIGN, SETTING, AND PATIENTS: The Heart Failure Adherence and Retention Trial (HART), a single-center, multiple-hospital, partially blinded behavioral efficacy randomized controlled trial involving 902 patients with mild to moderate heart failure and reduced or preserved systolic function, randomized from the Chicago metropolitan area between October 2001 and October 2004 and undergoing follow-up for 2 to 3 subsequent years. INTERVENTIONS: All patients were offered 18 contacts and 18 heart failure educational tip sheets during the course of 1 year. Patients randomized to the education group received tip sheets in the mail and telephone calls to check comprehension. Patients randomized to the self-management group received tip sheets in groups and were taught self-management skills to implement the advice. MAIN OUTCOME MEASURE: Death or heart failure hospitalization during a median of 2.56 years of follow-up. RESULTS: Patients were representative of typical clinical populations (mean age, 63.6 years; 47% women, 40% racial/ethnic minority, 52% with annual family income less than $30,000, and 23% with preserved systolic function). The rate of the primary end point in the self-management group was no different from that in the education group (163 [40.1%)] vs 171 [41.2%], respectively; odds ratio, 0.95 [95% confidence interval, 0.72-1.26]). There were no significant differences on any secondary end points, including death, heart failure hospitalization, all-cause hospitalization, or quality of life. CONCLUSIONS: Compared with an enhanced educational intervention alone, the addition of self-management counseling did not reduce death or heart failure hospitalization in patients with mild to moderate heart failure. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00018005.
Authors:
Lynda H Powell; James E Calvin; Dejuran Richardson; Imke Janssen; Carlos F Mendes de Leon; Kristin J Flynn; Kathleen L Grady; Cheryl S Rucker-Whitaker; Claudia Eaton; Elizabeth Avery;
Related Documents :
19930618 - Pulmonary artery catheters in acute heart failure: end of an era?
22763158 - Quantification of left ventricular myocardial collagen system in children, young adults...
24180538 - Recent developments in the ablation of ventricular arrhythmias.
19481278 - The effect of treatment with bisoprolol-first versus enalapril-first on cardiac structu...
17622358 - Influence of 677 c-->t polymorphism of methylenetetrahydrofolate reductase on medium-te...
8664018 - Randomized trial comparing intermittent antegrade warm blood cardioplegia with multidos...
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  JAMA : the journal of the American Medical Association     Volume:  304     ISSN:  1538-3598     ISO Abbreviation:  JAMA     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-22     Completed Date:  2010-09-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1331-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Preventive Medicine, Rush University Medical Center, 1700 W Van Buren St, Chicago, IL 60612, USA. lpowell@rush.edu
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00018005
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Directive Counseling*
Female
Heart Failure / mortality,  therapy*
Hospitalization / statistics & numerical data
Humans
Male
Middle Aged
Motivation
Odds Ratio
Patient Compliance*
Patient Education as Topic*
Quality of Life
Self Care*
Single-Blind Method
Treatment Outcome
Grant Support
ID/Acronym/Agency:
HL065547/HL/NHLBI NIH HHS
Investigator
Investigator/Affiliation:
Lynda H Powell / ; James E Calvin / ; Dejuran Richardson / ; Imke Janssen / ; Carlos F Mendes de Leon / ; Kristin J Flynn / ; Kathleen L Grady / ; Cheryl S Rucker-Whitaker / ; Claudia Eaton / ; Elizabeth Avery / ; Jared Jobe / ; Peter Kaufmann / ; Cheryl Brody / ; Leslie Brookfield / ; Stephanie Dunlap / ; Philip Krause / ; Stuart Rosenbush / ; William Elliott / ; Donald Tanis / ; Mitchell Saltzberg / ; Maria Rosa Costanzo / ; Michael Shapiro / ; Thomas Stamos / ; Marc A Silver / ; Michael Waligora / ; Randall Williams / ; Kristin J Flynn / ; Andrea Kozak / ; Carl Thoresen / ; Virginia Price / ; Susan Gilkey / ; Maureen Gecht / ; Jim Jarzenbowski / ; Kevin McClone / ; Carmen Lynas / ; Sybil Madison-Boyd / ; Marilynn Rochon / ; Bruce Rybarczyk / ; Sarah Sellergren / ; Stephen Tate / ; Tamara Gathright / ; Rocio Munoz / ; Cheryl S Rucker-Whitaker / ; Lynda H Powell / ; Kim Lebowitz / ; Patty Roberts / ; Ayesha Shaikh / ; Marilyn Vander Werf / ; Kathleen L Grady / ; James E Calvin / ; Stamatis Dimitropoulos / ; William Elliott / ; Philip Kraus / ; Payman Sattar / ; Sujata Shanbhag / ; Thomas Stamos / ; Patricia Vassallo / ; Lawrence S Cohen / ; Baruch A Brody / ; Byron W Brown / ; Nancy R Cook / ; Julie Buring / ; Robert M Kaplan / ; Lynn Warner Stevenson / ; David Thomasma /
Comments/Corrections
Comment In:
JAMA. 2010 Sep 22;304(12):1383-4   [PMID:  20858885 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Distinguishing hemorrhagic stroke from ischemic stroke.
Next Document:  Association of telomere length of peripheral blood leukocytes with hematopoietic relapse, malignant ...