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  • Ervention group reported monitoring weights daily (79 vs. 29 , p <0.0001). After adjusting for

  • 12 May 2021 by 0 Comments

Ervention group reported monitoring weights daily (79 vs. 29 , p < 0.0001). After adjusting for baseline demographic and treatment differences, we found no difference in heart failure-related quality of life at 12 months (difference = -2; CI -5, +9). Conclusion: A primary care-based heart failure self-management program designed for patients with low literacy reduces the risk of hospitalizations or death.Page 1 of(page number not for citation purposes)BMC Health Services Research 2006, 6:http://www.biomedcentral.com/1472-6963/6/BackgroundLimited literacy skills are common among adults in the United States [1]. Low literacy is associated with increased risk of hospitalization and worse control of chronic diseases [1-4]. Heart failure is a common chronic illness requiring multiple medications and significant self-care. Heart failure is the leading cause of hospitalization in the Medicare population [5]. The complexity of care for heart failure puts people with PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/2447481 low literacy at considerable risk for adverse outcomes including hospitalization, worse quality of life, and mortality. Heart failure disease-management interventions appear effective in reducing rehospitalizations and improving quality of life [6]. Most randomized clinical trials of heart failure disease management completed over the last 10 years have enrolled patients during, or shortly after, hospitalization and reported the outcome of readmission [6]. Although the designs of these programs vary, several have tested education and support to enhance patient selfmanagement as PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/7667330 the main component of the intervention [7-10]. The content of self-management education usually includes teaching to understand medications, reduce salt intake, monitor daily weights, and recognize symptoms. Most programs include structured follow-up either by home visit, phone, or mail. Only a few, uncontrolled studies specifically ask patients to self-adjust their diuretics [11,12]. Heart failure self-management programs may be particularly effective for vulnerable populations, such as those with poor literacy [13,14]. However, to our knowledge, no previous studies have explicitly examined the role of self-management programs in a low literacy population. A recently published study and accompanying editorial suggested that such self-management support may be most effective among vulnerable populations [13,14]. Low literacy may represent a vulnerability for which we should design our programs. Disease management PYBG-TMR for patients with low literacy may require refined approaches to foster self-management skills. We developed a heart failure selfmanagement program for use by patients with a variety of literacy levels [15]. We performed a randomized controlled trial comparing our self-management program to usual care among outpatients to test if the program could reduce hospitalizations and improve heart failure-related quality of life.and 70 medical residents, cares for over 500 patients with heart failure.Study participants To be eligible, patients had to have a clinical diagnosis of heart failure confirmed by their primary provider through a direct interview, and one of the following: 1) chest x-ray findings consistent with heart failure, 2) ejection fraction <40 by any method, or 3) a history of peripheral edema. They also had to have New York Heart Association class IIIV symptoms within the last 3 months. Patients were excluded if they had moderate to severe dementia (based on the treating physician's clinica.

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