Health> Vol.6 No.7, March 2014
Views: 846    Downloads: 232

36-Month Follow-Up Study of Post-Intervention Chronic Heart Failure Patients

DownloadDownload as PDF (Size:2443KB) Full-Text HTML PP. 559-575   DOI: 10.4236/health.2014.67075

ABSTRACT

Aim: Although numerous studies of disease management and case management of chronic heart failure (CHF) have been carried out, length of effectiveness after program commencement has not been examined, so we examined a follow-up study at 36 months after program commencement. Methods: Participants went for follow-up visits to one Japanese clinic which specializes in internal cardiovascular medicine and they were given diagnoses of CHF. 104 outpatients participated in this study and randomized control trial was implemented. An educational program was implemented for 6 months. The data were collected at baseline, 3, 6, 9, 12 months from both intervention and control groups and at 24 and 36 months from the intervention group. Results: There was significant improvement in New York Heart Association (NYHA) in the intervention group between baseline and 36 months. Improvement in weight monitoring and activities or exercise in the intervention group continued up to 36 months. Meanwhile, sodium restricted diets and quitting smoking and/or drinking depended on individual preference and it was difficult to make improvements in these areas. Conclusions: The educational program showed promise in preventing CHF outpatients from deteriorating significantly on a long-term basis as self-monitoring of activity and weight continued significantly and there were no participants with CHF who deteriorated in the intervention group at 36 months after program commencement, although the program aimed only to provide illness and self-management knowledge. On the other hand, future work will need to compare participants in this program to a control group over an extended period of time with consideration for relieving the burden of the control group.

KEYWORDS


Cite this paper

Otsu, H. and Moriyama, M. (2014) 36-Month Follow-Up Study of Post-Intervention Chronic Heart Failure Patients. Health, 6, 559-575. doi: 10.4236/health.2014.67075.

References

[1] Shibata, N., Watanabe, J., Shinozaki, T., Koseki, Y., Sakuma, M., Kagaya, Y., Shirato, K., CHART Investigators (2004) Analysis of Chronic Heart Failure Registry in the Tohoku District Third Year Follow-Up. Circulation Journal, 68, 427-434.
http://dx.doi.org/10.1253/circj.68.427
[2] Stewart, S., Marley, J.E. and Horowitz, J.D. (1999) Effects of a Multidisciplinary, Home-Based Intervention on Planned Readmissions and Survival among Patients with Chronic Congestive Heart Failure: A Randomized Controlled Study. Lancet, 354, 1077-1083.
http://dx.doi.org/10.1016/S0140-6736(99)03428-5
[3] Riegel, B., Carlson, B., Glaser, D. and Hoagland, P. (2000) Which Patients with Heart Failure Respond Best to Multi-disciplinary Disease Management? Journal of Cardiac Failure, 6, 290-299.
http://dx.doi.org/10.1054/jcaf.2000.19226
[4] Smeulders, E.S., van Haastregt, J.C., van Hoef, E.F., van Eijk, J.T. and Kempen, G.I. (2006) Evaluation of a Self-Management Programme for Congestive Heart Failure Patients: Design of a Randomized Controlled Trial. BMC Health Services Research, 6, 91.
http://www.biomedcentral.com/content/pdf/1472-6963-6-91.pdf
http://dx.doi.org/10.1186/1472-6963-6-91
[5] Sidorov, J. (2006) Reduced Health Care Costs Associated with Disease Management for Chronic Heart Failure: A Study Using Three Methods to Examine the Financial Impact of a Heart Failure Disease Management Program among Medicare Advantage Enrollees. Journal of Cardiac Failure, 12, 594-600.
http://dx.doi.org/10.1016/j.cardfail.2006.07.006
[6] Peters-Klimm, F., Müller-Tasch, T., Schellberg, D., Gensichen, J., Muth, C., Herzog, W. and Szecsenyi, J. (2007) Rationale, Design and Conduct of a Randomised Controlled Trial Evaluating a Primary Care-Based Complex Intervention to Improve the Quality of Life of Heart Failure Patients: HICMan (HeidelbergIntegrated Case Management). BMC Cardiovascular Disorders, 7.
http://www.biomedcentral.com/1471-2261/7/25
[7] Smeulders, E.S., van Haastregt, J.C., Janssen-Boyne, J.J., Stoffers, H.E., van Eijk, J.T. and Kempen, G.I. (2009) Feasibility of a Group-Based Self-Management Program among Congestive Heart Failure Patients. Heart Lung, 38, 499-512.
http://dx.doi.org/10.1016/j.hrtlng.2009.01.007
[8] Smeulders, E.S., van Haastregt, J.C., Ambergen, T., Uszko-Lencer, N.H., Janssen-Boyne, J.J., Gorgels, A.P., Stoffers, H.E., Lodewijksvan der Bolt, C.L., van Eijk, J.T. and Kempen, G.I. (2010) Nurse-Led Self-Management Group Programme for Patients with Congestive Heart Failure: Randomized Controlled Trial. Journal of Advanced Nursing, 66, 1487-1499.
http://dx.doi.org/10.1111/j.1365-2648.2010.05318.x
[9] Otsu, H. and Moriyama, M. (2011) Effectiveness of an Educational Self-Management Program for Outpatients with Chronic Heart Failure. Japan Journal of Nursing Science, 8, 140-152.
http://dx.doi.org/10.1111/j.1742-7924.2010.00166.x
[10] Lowery, J., Hopp, F., Subramanian, U., Wiitala, W., Welsh, D.E., Larkin, A., Stemmer, K., Zak, C. and Vaitkevicius, P. (2012) Evaluation of a Nurse Practitioner Disease Management Model for Chronic Heart Failure: A Multi-Site Implementation Study. Congestive Heart Failure, 18, 64-71.
http://dx.doi.org/10.1111/j.1751-7133.2011.00228.x
[11] Otsu, H. and Moriyama, M. (2012) A Follow-Up Study for a Disease Management Program for Chronic Heart Failure 24 Months after Program Commencement. Japan Journal of Nursing Science, 9, 136-148.
http://dx.doi.org/10.1111/j.1742-7924.2011.00194.x
[12] Azeyanagi, A., Oshima, M., Kamide, T., Yamahara, Y., Ebisawa, T., Umamoto, I., Nakagawa, H., Kubota, S. and Okamura, Y. (2005) The Present Situation of Elderly Patients with Heart Failure Who Were under Medical Treatment in the Hospital—An Investigation of the Current Situation and Problems among very Elderly Patients with Heart Failure. Kyoto Medical Journal, 52, 71-76.
[13] Otsu, H. and Moriyama, M. (2008) The Realities Regarding Self-Management of Chronic Heart Failure and the Relationship between Self-Management and Clinical Indicator of Chronic Heart Disease. Journal of Health Sciences Hiroshima University, 7, 66-76.
[14] Prochaska, J.O., Butterworth, S., Redding, C.A., Burden, V., Perrin, N., Leo, M., Flaherty-Robb, M. and Prochaska, J.M. (2008) Initial Efficacy of MI, TTM Tailoring and HRI’s with Multiple Behaviors for Employee Health Promotion. Preventive Medicine, 46, 226-231.
http://dx.doi.org/10.1016/j.ypmed.2007.11.007
[15] Otsu, H., Moriyama, M. and Nakaya, T. (2010) Development of a Japanese Version of the MacNew Heart Disease Health-Related Quality of Life Questionnaire. Journal of Japan Academy of Nursing Science, 30, 91-99.
http://dx.doi.org/10.5630/jans.30.1_91
[16] Höfer, S., Lim, L.L., Guyatt, G.H. and Oldridge, N. (2004) The MacNew Heart Disease Health-Related Quality of Life Instrument: A Summary. Health and Quality of Life Outcomes, 2, 3.
http://www.biomedcentral.com/content/pdf/1477-7525-2-3.pdf
http://dx.doi.org/10.1186/1477-7525-2-3
[17] Koelling, T.M., Johnson, M.L., Cody, R.J. and Aaronson, K.D. (2005) Discharge Education Improve Clinical Outcomes in Patients with Chronic Heart Failure. Circulation, 111, 179-185.
http://dx.doi.org/10.1161/01.CIR.0000151811.53450.B8
[18] Blue, L., Lang, E., McMurray, J.J., Davie, A.P., McDonagh, T.A., Murdoch, D.R., Petrie, M.C., Connolly, E., Norrie, J., Round, C.E., Ford, I. and Morrison, C.E. (2001) Randomised Controlled Trial of Specialist Nurse Intervention in Heart Failure. British Medical Journal, 323, 715-718.
http://dx.doi.org/10.1136/bmj.323.7315.715
[19] Noordman, J., de Vet, E., van der Weijden, T. and van Dulmen, S. (2013) Motivational Interviewing within the Different Stages of Change: An Analysis of Practice Nurse-Patient Consultations Aimed at Promoting a Healthier Life-style. Social Science & Medicine, 87, 60-67.
http://dx.doi.org/10.1016/j.socscimed.2013.03.019
[20] Butler, C.C., Simpson, S.A., Hood, K., Cohen, D., Pickles, T., Spanou, C., McCambridge, J., Moore, L., Randell, E., Alam, M.F., Kinnersley, P., Edwards, A., Smith, C. and Rollnick, S. (2013) Training Practitioners to Deliver Opportunistic Multiple Behaviour Change Counselling in Primary Care: A Cluster Randomised Trial. British Medical Journal, 346, 10-13.
http://dx.doi.org/10.1136/bmj.f1191
[21] The Japanese Dental Health Society, The Japanese Society of Oral and Maxillofacial Surgeons, The Japanese Society of Public Health, The Japanese Respiratory Society, The Japan Society of Obstetrics and Gynecology, The Japanese Circulation Society, The Japan Pediatric Society, The Japanese College of Cardiology and The Japan Lung Cancer Society (2010) Guidelines for Smoking Cessation. 1-85.
[22] The Japanese Circulation Society (2010) Guidelines for Treatment of Chronic Heart Failure. 1-85.
[23] Masunaga, N., Kimura, A., Miyataka, M. and Ichikawa, T. (2003) Effects of Cardiac Events Caused by Drinking in Patients with Old Myocardial Infarction. Medical Journal Kinki University, 28, 223-238.
[24] West, J.A., Miller, N.H., Parker, K.M., Senneca, D., Ghandour, G., Clark, M., Greenwald, G., Heller, R.S., Fowler, M.B. and DeBusk, R.F. (1997) A Comprehensive Management System for Heart Failure Improves Clinical Outcomes and Reduces Medical Resource Utilization. The American Journal of Cardiology, 79, 58-63.
http://dx.doi.org/10.1016/S0002-9149(96)00676-5

comments powered by Disqus

Copyright © 2014 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.