AIMS: Mild cognitive impairment (MCI) is prevalent in heart failure, and can contribute to poor self-care and higher hospital readmissions. Strategies to improve self-care in patients with MCI have not been studied. This randomized controlled trial aimed to test the effect of a targeted intervention on self-care, heart failure knowledge, and 30-day readmissions. METHODS AND RESULTS: The study included 125 patients hospitalized for exacerbation of heart failure who screened positive for MCI. The treatment group received a targeted self-care teaching intervention using principles of cognitive training. Self-care, heart failure knowledge, depression, and social support were assessed at baseline and 30 days post-discharge. Mean heart failure knowledge scores improved significantly in the intervention group, but decreased in the control group (P < 0.001). When controlling for other variables, patients in the intervention group showed a greater increase in heart failure knowledge than patients in the control group (P = 0.027). Black race was significantly associated with lower heart failure knowledge scores (P = 0.030). Mean change scores for self-care showed greater improvement in the intervention group when compared with the control group; however, this was not statistically significant. There was no difference in readmission rates between the groups. CONCLUSION: It is feasible to conduct a randomized controlled trial in patients with MCI. Patients in the treatment group had greater heart failure knowledge at 30 days post-discharge; however, this did not impact readmission rates. Further research is needed to describe how MCI affects self-care and knowledge, and how race and other factors may influence outcomes in this population.
RCT Entities:
AIMS: Mild cognitive impairment (MCI) is prevalent in heart failure, and can contribute to poor self-care and higher hospital readmissions. Strategies to improve self-care in patients with MCI have not been studied. This randomized controlled trial aimed to test the effect of a targeted intervention on self-care, heart failure knowledge, and 30-day readmissions. METHODS AND RESULTS: The study included 125 patients hospitalized for exacerbation of heart failure who screened positive for MCI. The treatment group received a targeted self-care teaching intervention using principles of cognitive training. Self-care, heart failure knowledge, depression, and social support were assessed at baseline and 30 days post-discharge. Mean heart failure knowledge scores improved significantly in the intervention group, but decreased in the control group (P < 0.001). When controlling for other variables, patients in the intervention group showed a greater increase in heart failure knowledge than patients in the control group (P = 0.027). Black race was significantly associated with lower heart failure knowledge scores (P = 0.030). Mean change scores for self-care showed greater improvement in the intervention group when compared with the control group; however, this was not statistically significant. There was no difference in readmission rates between the groups. CONCLUSION: It is feasible to conduct a randomized controlled trial in patients with MCI. Patients in the treatment group had greater heart failure knowledge at 30 days post-discharge; however, this did not impact readmission rates. Further research is needed to describe how MCI affects self-care and knowledge, and how race and other factors may influence outcomes in this population.
Authors: Misty A W Hawkins; Mary A Dolansky; Jennifer B Levin; Julie T Schaefer; John Gunstad; Joseph D Redle; Richard Josephson; Joel W Hughes Journal: Heart Lung Date: 2016 Sep-Oct Impact factor: 2.210
Authors: Veli-Pekka Harjola; Wilfried Mullens; Marek Banaszewski; Johann Bauersachs; Hans-Peter Brunner-La Rocca; Ovidiu Chioncel; Sean P Collins; Wolfram Doehner; Gerasimos S Filippatos; Andreas J Flammer; Valentin Fuhrmann; Mitja Lainscak; Johan Lassus; Matthieu Legrand; Josep Masip; Christian Mueller; Zoltán Papp; John Parissis; Elke Platz; Alain Rudiger; Frank Ruschitzka; Andreas Schäfer; Petar M Seferovic; Hadi Skouri; Mehmet Birhan Yilmaz; Alexandre Mebazaa Journal: Eur J Heart Fail Date: 2017-05-30 Impact factor: 15.534
Authors: Aaron L Leppin; Michael R Gionfriddo; Maya Kessler; Juan Pablo Brito; Frances S Mair; Katie Gallacher; Zhen Wang; Patricia J Erwin; Tanya Sylvester; Kasey Boehmer; Henry H Ting; M Hassan Murad; Nathan D Shippee; Victor M Montori Journal: JAMA Intern Med Date: 2014-07 Impact factor: 21.873
Authors: Juliana de Melo Vellozo Pereira Tinoco; Lyvia da Silva Figueiredo; Paula Vanessa Peclat Flores; Bruna Lins Rocha de Padua; Evandro Tinoco Mesquita; Ana Carla Dantas Cavalcanti Journal: Rev Lat Am Enfermagem Date: 2021-07-19