Quality of Life Research

, Volume 23, Issue 1, pp 31–38 | Cite as

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
Article

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Heart failure Quality of life Self-management 

Abbreviations

HF

Heart failure

HRQOL

Health-related quality of life

HART

Heart failure adherence and retention trial

NYHA

New York Heart Association

QLI

Quality of Life Index

SF-36

Short Form 36

GDS

Geriatric Depression Scale

ACE

Angiotensin-converting enzyme

ARB

Angiotensin-receptor blocker

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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

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