Heart failure patients with a lower educational level and better cognitive status benefit most from a self-management group programme.
OBJECTIVE
The Chronic Disease Self-Management Programme (CDSMP)was recently evaluated among patients with congestive heart failure (CHF) in a randomized controlled trial (n = 317) with twelve months of follow-up after the start of the programme. That trial demonstrated short-term improvements in cardiac-specific quality of life. The current study assessed which of the patients participating in this trial benefited most from the CDSMP with respect to cardiac-specific quality of life.


METHODS
Subgroup analyses were conducted using mixed-effects linear regression models to assess the relationship between patient characteristics and the effects of the CDSMP on cardiac-specific quality of life.


RESULTS
In the short term, patients with better cognitive status benefited more from the CDSMP than their poorer functioning counterparts. In addition, lower educated patients benefited more from the CDSMP than their higher educated counterparts during total follow-up.


CONCLUSIONS
Subgroup effects were found for cognitive status and educational level. Future research should be performed to validate current findings and further explore the conditions under which CHF patients may benefit more from the programme.


CONCLUSIONS
These results indicate that lower educated patients, in particular, should be encouraged to participate in the CDSMP. In addition, healthcare practitioners are recommended to take into account potential cognitive impairments of patients.
Department of Health Care and Nursing Science, Maastricht University/CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands. e.smeulders@zw.unimaas.nl
Esther S T F
ES
Smeulders
Jolanda C M
JC
van Haastregt
Ton
T
Ambergen
Henri E J H
HE
Stoffers
Josiane J J
JJ
Janssen-Boyne
Nicole H K M
NH
Uszko-Lencer
Anton P M
AP
Gorgels
Cara L B
CL
Lodewijks-van der Bolt
Jacques Th M
JT
van Eijk
Gertrudis I J M
GI
Kempen
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003071:Cognition / Q000502:physiology*; D004522:Educational Status; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic; D010358:Patient Participation; D011788:Quality of Life; D012648:Self Care; D020377:Self Efficacy