title: Does self-management counseling in patients with heart failure improve quality of life? Findings from the Heart Failure Adherence and Retention Trial (HART).
abstract: OBJECTIVE
  Heart failure (HF) is associated with poor health-related quality of life (HRQOL). The purpose of our study is to determine the effect of a self-management intervention on HRQOL domains across time, overall, and in prespecified demographic, clinical, and psychosocial subgroups of HF patients.
  
  
  METHODS
  HART was a single-center, multi-hospital randomized trial. Patients (n = 902) were randomized either to a self-management intervention with provision of HF educational information or an enhanced education control group which received the same HF educational materials. HRQOL was measured by the Quality of Life Index, Cardiac Version, modified, and the Medical Outcomes Study 36-item Short-Form Health Survey physical functioning scale. Analyses included descriptive statistics and mixed-effects regression models.
  
  
  RESULTS
  In general, overall, study participants' HRQOL improved over time. However, no significant differences in HRQOL domain were detected between treatment groups at baseline or across time (p > 0.05). Subgroup analyses demonstrated no differences by treatment arm for change in HRQOL from baseline to 3 years later.
  
  
  CONCLUSIONS
  We conclude that in our cohort of patients, the self-management intervention had no benefit over enhanced education in improving domains of HRQOL and HRQOL for specified HF subgroups.
authors.affiliation: Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA, kgrady@nmh.org.
authors.forename: Kathleen L
authors.initials: KL
authors.lastname: Grady
authors.forename: Carlos F Mendes
authors.initials: CF
authors.lastname: de Leon
authors.forename: Andrea T
authors.initials: AT
authors.lastname: Kozak
authors.forename: John F
authors.initials: JF
authors.lastname: Cursio
authors.forename: DeJuran
authors.initials: D
authors.lastname: Richardson
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Avery
authors.forename: James E
authors.initials: JE
authors.lastname: Calvin
authors.forename: Lynda H
authors.initials: LH
authors.lastname: Powell
mesh_terms: D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D003376:Counseling / Q000379:methods*; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000188:drug therapy / Q000517:prevention & control / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011615:Psychotherapy, Group; D011788:Quality of Life; D012107:Research Design; D012648:Self Care / Q000379:methods*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors