title: Improving heart failure self-management support by actively engaging out-of-home caregivers: results of a feasibility study.
abstract: The benefits of heart failure (HF) care management have been demonstrated, yet health systems are often unable to meet patients' needs for support between outpatient visits. Informal care provided by family or friends is a low-cost, and potentially effective, adjunct to care management services. The authors evaluated the feasibility of augmenting HF care management with weekly, automated assessment and behavior change calls to patients, feedback via the Internet to an out-of-home informal caregiver or CarePartner (CP), and faxes to the patient's health care team. The program included 52 HF patient-CP pairs participating for an average of 12 weeks. Patients completed 586 assessments (92% completion rate) and reported problems that might otherwise have gone unidentified. At follow-up, 75% had made changes in their self-care as a result of the intervention. The CP program may extend the impact of HF telemonitoring beyond what care management programs can realistically deliver.
authors.affiliation: Department of Veterans Affairs, Ann Arbor VA HSR&D Center of Excellence, Ann Arbor, MI 48113, USA. jpiette@umich.edu
authors.forename: John D
authors.initials: JD
authors.lastname: Piette
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Gregor
authors.forename: David
authors.initials: D
authors.lastname: Share
authors.forename: Michele
authors.initials: M
authors.lastname: Heisler
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Bernstein
authors.forename: Todd
authors.initials: T
authors.lastname: Koelling
authors.forename: Paul
authors.initials: P
authors.lastname: Chan
mesh_terms: D000328:Adult; D000368:Aged; D017028:Caregivers; D003142:Communication; D005240:Feasibility Studies; D005260:Female; D006305:Health Status Indicators; D006306:Health Surveys; D006333:Heart Failure / Q000523:psychology*; D006699:Home Care Services; D006801:Humans; D020407:Internet; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019114:Remote Consultation; D012648:Self Care; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D012944:Social Support; D011795:Surveys and Questionnaires; D016896:Treatment Outcome