Abstract 1255: Improvement in Self-Care Behaviors and Outcomes for Patients With Heart Failure Using the Medication Education & Decision-Making (MED) Intervention
Failure of patients with heart failure (HF) patients to comply with the recommended medical regimen is associated with HF exacerbation and possible hospitalization. The purpose of this experimental study was to examine the impact of the MED intervention for elderly patients (≥65 years of age) with HF on self-care behaviors and outcomes for medication use and self-efficacy. The conceptual model for medication adherence (Murray et al., 2004) served as the basis for development of the MED intervention. A baseline screening of self-care behaviors was used to tailor self-care educational materials and two educational and coaching sessions. The study sample included 40 subjects who had been hospitalized with a primary or secondary diagnosis of HF. Subjects had a mean age of 76.9±6.5 years, ranging from 65 to 90 years. Subjects included 26 males and 14 females; with NYHA Class II (42.5%), III (55%) or IV (2.5%) HF.
Methods: A prospective, repeated measures experimental design was used. Baseline data were obtained within 48 hours of discharge, and at follow-up times (1- and 3-months after hospitalization). The Brief Medication Questionnaire (BMQ) and Kansas City Cardiomyopathy Questionnaire (KCCQ) were used to measure self-care behaviors and outcomes.
Findings: Using repeated measures analysis of covariance (RM ANCOVA). There were no significant time by group interactions; however there were significant main effects for group. The MED intervention group had significantly higher self-care behavior scores, using the BMQ, for knowing medication names [F(3,35)= 4.9, p<.05], knowing the reasons for medication use [F(3,35)= 14.5, p<.001] and remembering to take their medications [F(3,34)= 14.8, p<.001]. The MED group had higher self-care outcomes for medication use on the BMQ [F(3,35)= 8.3, p<.01], and self-efficacy for HF self-care management [F(3,35)= 17.9, p<.0001] using the KCCQ. In conclusion, the MED intervention was useful to enhance self-care behaviors for medication use and improve self-care outcomes of medication use and self-care self-efficacy in patients with HF following hospitalization. Further study is warranted to evaluate the mechanism of the intervention by measuring more specific self-care maintenance and management behaviors.