The effect of progressive, reinforcing telephone education and counseling versus brief educational intervention on knowledge, self-care behaviors and heart failure symptoms

J Card Fail. 2011 Oct;17(10):789-96. doi: 10.1016/j.cardfail.2011.06.374. Epub 2011 Jul 23.

Abstract

Background: The optimal strategy for promoting self-care for heart failure (HF) is unclear.

Methods and results: We conducted a randomized trial to determine whether a "teach to goal" (TTG) educational and behavioral support program provided incremental benefits to a brief (1 hour) educational intervention (BEI) for knowledge, self-care behaviors, and HF-related quality of life (HFQOL). The TTG program taught use of adjusted-dose diuretics and then reinforced learning goals and behaviors with 5 to 8 telephone counseling sessions over 1 month. Participants' (n = 605) mean age was 61 years; 37% had marginal or inadequate literacy; 69% had ejection fraction <0.45; and 31% had Class III or IV symptoms. The TTG group had greater improvements in general and salt knowledge (P < .001) and greater increases in self-care behaviors (from mean 4.8 to 7.6 for TTG vs. 5.2 to 6.7 for BEI; P < .001). HFQOL improved from 58.5 to 64.6 for the TTG group but did not change for the BEI group (64.7 to 63.9; P < .001 for the difference in change scores). Improvements were similar regardless of participants' literacy level.

Conclusions: Telephone reinforcement of learning goals and self-care behaviors improved knowledge, health behaviors, and HF-related QOL compared to a single education session.

Trial registration: ClinicalTrials.gov NCT00378950.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Counseling
  • Diuretics / administration & dosage
  • Female
  • Health Behavior*
  • Heart Failure / pathology
  • Heart Failure / prevention & control*
  • Humans
  • Male
  • Middle Aged
  • Patient Education as Topic
  • Program Evaluation
  • Quality of Life*
  • Self Care*
  • Severity of Illness Index
  • Telemedicine*
  • Treatment Outcome

Substances

  • Diuretics

Associated data

  • ClinicalTrials.gov/NCT00378950