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Effect of a sequential education and monitoring programme on quality‐of‐life components in heart failure
Author(s) -
Cruz Fátima das Dores,
Issa Victor Sarli,
AyubFerreira Silvia Moreira,
Chizzola Paulo Roberto,
Souza Germano Emilio Conceição,
Moreira Luiz Felipe Pinho,
LanzLuces José Ramón,
Bocchi Edimar Alcides
Publication year - 2010
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfq130
Subject(s) - medicine , heart failure , ejection fraction , quality of life (healthcare) , heart transplantation , randomized controlled trial , cardiology , nursing
Aims Trials of disease management programmes (DMP) in heart failure (HF) have shown controversial results regarding quality of life. We hypothesized that a DMP applied over the long‐term could produce different effects on each of the quality‐of‐life components. Methods and results We extended the prospective, randomized REMADHE Trial, which studied a DMP in HF patients. We analysed changes in Minnesota Living with Heart Failure Questionnaire components in 412 patients, 60.5% male, age 50.2 ± 11.4 years, left ventricular ejection fraction 34.7 ± 10.5%. During a mean follow‐up of 3.6 ± 2.2 years, 6.3% of patients underwent heart transplantation and 31.8% died. Global quality‐of‐life scores improved in the DMP intervention group, compared with controls, respectively: 57.5 ± 3.1 vs. 52.6 ± 4.3 at baseline, 32.7 ± 3.9 vs. 40.2 ± 6.3 at 6 months, 31.9 ± 4.3 vs. 41.5 ± 7.4 at 12 months, 26.8 ± 3.1 vs. 47.0 ± 5.3 at the final assessment; P < 0.01. Similarly, the physical component (23.7 ± 1.4 vs. 21.1 ± 2.2 at baseline, 16.2 ± 2.9 vs. 18.0 ± 3.3 at 6 months, 17.3 ± 2.9 vs. 23.1 ± 5.7 at 12 months, 11.4 ± 1.6 vs. 19.9 ± 2.4 final; P < 0.01), the emotional component (13.2 ± 1.0 vs. 12.1 ± 1.4 at baseline, 11.7 ± 2.7 vs. 12.3 ± 3.1 at 6 months, 12.4 ± 2.9 vs. 16.8 ± 5.9 at 12 months, 6.7 ± 1.0 vs. 10.6 ± 1.4 final; P < 0.01) and the additional questions (20.8 ± 1.2 vs. 19.3 ± 1.8 at baseline, 14.3 ± 2.7 vs. 17.3 ± 3.1 at 6 months, 12.4 ± 2.9 vs. 21.0 ± 5.5 at 12 months, 6.7 ± 1.4 vs. 17.3 ± 2.2 final; P < 0.01) were better (lower) in the intervention group. The emotional component improved earlier than the others. Post‐randomization quality of life was not associated with events. Conclusion Components of the quality‐of‐life assessment responded differently to DMP. These results indicate the need for individualized DMP strategies in patients with HF. Trial registration information www.clincaltrials.gov NCT00505050—REMADHE.