Quality of Life Research

, Volume 23, Issue 1, pp 31–38

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

  • Kathleen L. Grady
  • Carlos F. Mendes de Leon
  • Andrea T. Kozak
  • John F. Cursio
  • DeJuran Richardson
  • Elizabeth Avery
  • James E. CalvinJr.
  • Lynda H. Powell

DOI: 10.1007/s11136-013-0432-7

Cite this article as:
Grady, K.L., de Leon, C.F.M., Kozak, A.T. et al. Qual Life Res (2014) 23: 31. doi:10.1007/s11136-013-0432-7



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.


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.


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.


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.


Heart failureQuality of lifeSelf-management



Heart failure


Health-related quality of life


Heart failure adherence and retention trial


New York Heart Association


Quality of Life Index


Short Form 36


Geriatric Depression Scale


Angiotensin-converting enzyme


Angiotensin-receptor blocker

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Kathleen L. Grady
    • 1
    • 7
  • Carlos F. Mendes de Leon
    • 2
  • Andrea T. Kozak
    • 3
  • John F. Cursio
    • 4
  • DeJuran Richardson
    • 4
    • 5
  • Elizabeth Avery
    • 4
  • James E. CalvinJr.
    • 6
  • Lynda H. Powell
    • 4
  1. 1.Department of Surgery, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  2. 2.Department of EpidemiologyUniversity of Michigan School of Public HealthAnn ArborUSA
  3. 3.Department of PsychologyOakland UniversityRochesterUSA
  4. 4.Department of Preventive MedicineRush University Medical CenterChicagoUSA
  5. 5.Department of Mathematics and Computer ScienceLake Forest CollegeLake ForestUSA
  6. 6.Department of CardiologyRush University Medical CenterChicagoUSA
  7. 7.Division of Cardiac SurgeryCenter for Heart Failure, Bluhm Cardiovascular InstituteChicagoUSA