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Does self-management counseling in patients with heart failure improve quality of life? Findings from the Heart Failure Adherence and Retention Trial (HART)

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Abstract

Purpose

Heart failure (HF) is associated with poor health-related quality of life (HRQOL). The purpose of our study is to determine the effect of a self-management intervention on HRQOL domains across time, overall, and in prespecified demographic, clinical, and psychosocial subgroups of HF patients.

Methods

HART was a single-center, multi-hospital randomized trial. Patients (n = 902) were randomized either to a self-management intervention with provision of HF educational information or an enhanced education control group which received the same HF educational materials. HRQOL was measured by the Quality of Life Index, Cardiac Version, modified, and the Medical Outcomes Study 36-item Short-Form Health Survey physical functioning scale. Analyses included descriptive statistics and mixed-effects regression models.

Results

In general, overall, study participants’ HRQOL improved over time. However, no significant differences in HRQOL domain were detected between treatment groups at baseline or across time (p > 0.05). Subgroup analyses demonstrated no differences by treatment arm for change in HRQOL from baseline to 3 years later.

Conclusions

We conclude that in our cohort of patients, the self-management intervention had no benefit over enhanced education in improving domains of HRQOL and HRQOL for specified HF subgroups.

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Abbreviations

HF:

Heart failure

HRQOL:

Health-related quality of life

HART:

Heart failure adherence and retention trial

NYHA:

New York Heart Association

QLI:

Quality of Life Index

SF-36:

Short Form 36

GDS:

Geriatric Depression Scale

ACE:

Angiotensin-converting enzyme

ARB:

Angiotensin-receptor blocker

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Acknowledgments

NIH, National Heart Lung and Blood Institute, HL065547, L. Powell (PI).

Author information

Authors and Affiliations

  1. Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Kathleen L. Grady

  2. Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA

    Carlos F. Mendes de Leon

  3. Department of Psychology, Oakland University, Rochester, MI, USA

    Andrea T. Kozak

  4. Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA

    John F. Cursio, DeJuran Richardson, Elizabeth Avery & Lynda H. Powell

  5. Department of Mathematics and Computer Science, Lake Forest College, Lake Forest, IL, USA

    DeJuran Richardson

  6. Department of Cardiology, Rush University Medical Center, Chicago, IL, USA

    James E. Calvin Jr.

  7. Division of Cardiac Surgery, Center for Heart Failure, Bluhm Cardiovascular Institute, 201 East Huron Street, Galter Pavilion 11-140, Chicago, IL, 60611-3056, USA

    Kathleen L. Grady

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  1. Kathleen L. Grady
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Correspondence to Kathleen L. Grady.

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Grady, K.L., de Leon, C.F.M., Kozak, A.T. et al. Does self-management counseling in patients with heart failure improve quality of life? Findings from the Heart Failure Adherence and Retention Trial (HART). Qual Life Res 23, 31–38 (2014). https://doi.org/10.1007/s11136-013-0432-7

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  • DOI: https://doi.org/10.1007/s11136-013-0432-7

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