Heart Failure Clinical Trial
Official title:
Effect of Behavioral Management on Quality of Life in Heart Failure
Nurses play an important role in helping patients to manage symptoms, adhere to treatment, and change behavior. There has been a lack of research regarding nonpharmacologic interventions with patients with heart failure and other chronic conditions.
Background:
Nurses play an important role in helping patients to manage symptoms, adhere to treatment,
and change behavior. There has been a lack of research regarding nonpharmacologic
interventions with patients with heart failure and other chronic conditions.
Objectives:
The primary objective of this 4-year study was to determine the effect of a nurse-led
behavioral management intervention on health-related quality in patients with
medically-managed heart failure. The secondary objective was to assess the impact of the
behavioral management intervention on health care resource utilization.
Methods:
DESIGN: randomized controlled trial. SETTING: single site, VA San Diego Healthcare System.
SAMPLE: Patients were enrolled in 11 cohorts a total of 116 outpatients were randomly
assigned to one of two treatment groups to evaluate the clinical impact of the intervention.
Group 1 received usual care for patients with heart failure (n=58). Group 2 was an augmented
group receiving usual care plus participation in the 15-week (4-month) behavioral management
program (n=58). Inclusion criteria were that the patient had a primary diagnosis of heart
failure, a VA primary care provider, stable symptoms for at least one month and was able to
walk. INTERVENTION: The behavioral management program augmented usual care and consisted of
establishing specific goals with patients related to healthier diet, increased quality and
amount of exercise, smoking cessation, and increased social and interpersonal activities.
DEPENDENT VARIABLES/OUTCOME MEASURES: The five major dependent variables for this study were
psychological symptom distress (Multiple Affect Adjective Check List - MAACL), physical
functioning (SF-36 physical component summary score), mental functioning (SF-36 mental
component summary score), exercise capability (6-Minute Walk), and general health
perceptions (SF-36 general health scale score). Dependent variables were assessed at
baseline, at the end of treatment (at 4 months), and then at 10 and 16 months. DATA
ANALYSIS: Initial analyses included all subjects who were randomized to treatment and
completed all data collection time points in a series of 2 by 4 ANOVAs with time as a
repeated measure.
Status:
Completed. Final report submitted August 2003
;
Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label
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