Discharge Education Improves Clinical Outcomes in Patients With Chronic Heart Failure
Top Cited Papers
- 18 January 2005
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 111 (2), 179-185
- https://doi.org/10.1161/01.cir.0000151811.53450.b8
Abstract
Background— Although interventions combining patient education and postdischarge management have demonstrated benefits in patients with chronic heart failure, the benefit attributable to patient education alone is not known. We hypothesized that a patient discharge education program would improve clinical outcomes in patients with chronic heart failure. Methods and Results— We conducted a randomized, controlled trial of 223 systolic heart failure patients and compared the effects of a 1-hour, one-on-one teaching session with a nurse educator to the standard discharge process. Subjects were contacted by telephone at 30, 90, and 180 days to collect information about clinical events, symptoms, and self-care practices. The primary end point of the study was the total number of days hospitalized or dead in the 180-day follow-up period. Subjects randomized to receive the teaching session (n=107) had fewer days hospitalized or dead in the follow-up period (0 and 10 days, median and 75th percentiles) than did controls (n=116, 4 and 19 days; P =0.009). Patients receiving the education intervention had a lower risk of rehospitalization or death (relative risk, 0.65; 95% confidence interval, 0.45 to 0.93; P =0.018). Costs of care, including the cost of the intervention, were lower in patients receiving the education intervention than in control subjects by $2823 per patient ( P =0.035). Conclusions— The addition of a 1-hour, nurse educator–delivered teaching session at the time of hospital discharge resulted in improved clinical outcomes, increased self-care measure adherence, and reduced cost of care in patients with systolic heart failure.Keywords
This publication has 20 references indexed in Scilit:
- Comprehensive Discharge Planning With Postdischarge Support for Older Patients With Congestive Heart FailureJama-Journal Of The American Medical Association, 2004
- Randomized trial of an education and support intervention to preventreadmission of patients with heart failureJournal of the American College of Cardiology, 2002
- ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary: A report of the american college of cardiology/american heart association task force on practice guidelines (committee to revise the 1995 guidelines for the evaluation and management of heart failure) developed in collaboration with the international society for heart and lung transplantation endorsed by the heart failure society of americaJournal of the American College of Cardiology, 2001
- In-person vs Telephone-administered Multiple-pass 24-hour Recalls in Women: Validation with Doubly Labeled WaterJournal of the American Dietetic Association, 2000
- HFSA guidelines for management of patients with heart failure caused by left ventricular systolic dysfunction—pharmacological approachesJournal of Cardiac Failure, 1999
- Effects of education and support on self-care and resource utilization in patients with heart failureEuropean Heart Journal, 1999
- A Multidisciplinary Intervention to Prevent the Readmission of Elderly Patients with Congestive Heart FailureThe New England Journal of Medicine, 1995
- The validity of self-reported smoking: a review and meta-analysis.American Journal of Public Health, 1994
- Effect of Enalapril on Survival in Patients with Reduced Left Ventricular Ejection Fractions and Congestive Heart FailureThe New England Journal of Medicine, 1991
- Measurement of Medication Compliance in a Clinical SettingArchives of Internal Medicine, 1979