Association of the induction of a self-care management system with 1-year outcomes in patients hospitalized for heart failure. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Nakane, Eisaku; Kato, Takao; Tanaka, Nozomi; Kuriyama, Tomoari; Kimura, Koki; Nishiwaki, Shushi; Hamaguchi, Toka; Morita, Yusuke; Yamaji, Yuhei; Haruna, Yoshisumi; Haruna, Tetsuya; Inoko, Moriaki
• Is Part Of: Journal of cardiology. Volume 77:Issue 1(2021)
• Page Start: 48
• Page End: 56
• Publication Date: 2021-01
• Subjects: Self-care management -- Heart failure -- Clinical outcomes; Cardiology -- Periodicals; 616.12
• DOI: 10.1016/j.jjcc.2020.07.015
• Languages: English
• ISSNs: 0914-5087

Abstract

Highlights: To improve self-care in patients with heart failure (HF), we developed a new self-care system. The weight and HF symptoms were scored ("Heart Failure Points"). The timing of consultations was clearly defined for patients. The new self-care system for HF was associated with better outcomes. Abstract: Background: To perform self-care in patients with heart failure (HF), we developed and implemented a new HF point self-care system, which was characterized by 1) the way weight and HF symptoms were scored ("Heart Failure Points") and 2) the timing of consultations defined for both patients and health care providers. We examined the association between the induction of the new system and 1-year outcomes in patients hospitalized for HF. Methods: We retrospectively enrolled 569 consecutive patients into our study who were admitted for HF treatment at our hospital: 275 patients between November 2011 and October 2013 (before the induction of the self-management system) and 294 patients between November 2015 and October 2017 (after the induction). We sought to compare the clinical outcomes between patients using the self-management system and those not using the system after propensity-score (PS) matching. The primary outcome measure was a composite of all-cause death or HF rehospitalization. Results: The cumulative 1-year incidence of the primary outcome measure in the use group (n = 153) was significantly lower than that in the non-use group (n = 153) (24.5% vs. 34.9%, respectively; p = 0.031; hazard ratio: 0.62; 95% confidence interval: 0.40−0.96), mainly due to a reduction in HF hospitalization. Conclusions: The induction of the new self-care system was associated with better 1-year outcomes in patients hospitalized for HF. This system may help patients with HF to achieve more efficient self-care.