A single educational intervention on Heart failure self-care: extended follow up from a multisite randomised controlled trial

Abstract

Background: Heart failure outcomes remain poor and little is known about the causes and predictors of these outcomes in Lebanon. Aim: To report the causes and predictors of the six and 12-month readmission and mortality of patients previously recruited to the FAMILY study. Methods: A multi-site block randomised controlled trial in three tertiary medical centres in Beirut. Initially, participants were randomised to either the control or the intervention group. The latter group, with their family caregivers, received heart failure self-care resources and an educational intervention on self-care and symptom management during their index admission. Participants from the FAMILY study were followed up with through phone calls for readmission and mortality at 6 and 12 months following their hospital discharge. Results: A total of 218 (85%) patients were followed up with for this evaluation. There was a significant difference between the intervention group and the control group in terms of mortality at 6 months (n= 18 (16%) vs. n=36 (33%); p<0.05) and 12 months (n=29 (26%) vs. n=45 (42%); p<0.05) post the index discharge. Mortality at 6 and 12 months was associated with aging, lower BMI scores and readmission at 30 days post the index admission. Results of a logistic regression for mortality at 6 months showed hypertensive etiology of heart failure to be the only significant predictor. Conclusion: A single session intervention showed significant improvement even after an extended period of time. Multi-session trials and longer periods of follow up are suggested for future studies to improve patient outcomes.