title: Impact of patient education on chronic heart failure in primary care (ETIC): a cluster randomised trial.
abstract: The Education Thérapeutique des patients Insuffisants Cardiaques (ETIC; Therapeutic Education for Patients with Cardiac Failure) trial aimed to determine whether a pragmatic education intervention in general practice could improve the quality of life of patients with chronic heart failure (CHF) compared with routine care.
  
  
  
  This cluster randomised controlled clinical trial included 241 patients with CHF attending 54 general practitioners (GPs) in France and involved 19 months of follow-up. The GPs in the Intervention Group were trained during a 2-day interactive workshop to provide a patient education programme. The mean age of the patients was 74 years (±10.5), 62 % were men and their mean left-ventricular ejection fraction was 49.3 % (± 14.3). At the end of the follow-up period, the mean Minnesota Living with Heart Failure Questionnaire scores in the Intervention and Control Groups were 33.4 (± 22.1) versus 27.2 (± 23.3; P = 0.74, intra-cluster coefficient [ICC] = 0.11). At the end of the follow-up period, the 36-Item Short Form Health Survey (mental health and physical health) scores in the Intervention and Control Groups were 58 (± 22.1) versus 58.7 (± 23.9; P = 0.58, ICC = 0.01) and 52.8 (± 23.8) versus 51.6 (± 25.5; P = 0.57, ICC = 0.01), respectively.
  
  
  
  Patient education delivered by GPs to elderly patients with stable heart failure in the ETIC programme did not achieve an improvement in their quality of life compared with routine care. Further research on improving the quality of life and clinical outcomes of elderly patients with CHF in primary care is necessary.
  
  
  
  The Education Thérapeutique des patients Insuffisants Cardiaques (ETIC; Therapeutic Education for Patients with Cardiac Failure) trial is a cluster randomised controlled trial registered with ClinicalTrials.gov (
  
  
  
  NCT01065142 ) and the French Drug Agency (Agence Nationale de Sécurité du Médicament et des Produits de Santé;
  
  
  
  2009-A01142-55).
authors.affiliation: General Practice Department, Faculty of Medicine of Clermont-Ferrand University, 28 Place Henri Dunant, 63000, Clermont-Ferrand, France. helene.vaillant_roussel@udamail.fr.|Clinical Investigation Center, INSERM CIC 1401, Clermont-Ferrand University Hospital, 58 Rue Montalembert, 63000, Clermont-Ferrand, France. helene.vaillant_roussel@udamail.fr.
authors.forename: Hélène
authors.initials: H
authors.lastname: Vaillant-Roussel
authors.affiliation: General Practice Department, Faculty of Medicine of Clermont-Ferrand University, 28 Place Henri Dunant, 63000, Clermont-Ferrand, France.|EA 7280 NPsy-Sydo, Faculty of Medicine of Clermont-Ferrand, University of Auvergne, 28 Place Henri Dunant, 63000, Clermont-Ferrand, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Laporte
authors.affiliation: Biostatistics unit, Clinical Research and Innovation Department, Clermont-Ferrand University Hospital, 58 Rue Montalembert, 63000, Clermont-Ferrand, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Pereira
authors.affiliation: General Practice Department, Faculty of Medicine of Clermont-Ferrand University, 28 Place Henri Dunant, 63000, Clermont-Ferrand, France.
authors.forename: Marion
authors.initials: M
authors.lastname: De Rosa
authors.affiliation: General Practice Department, Faculty of Medicine of Clermont-Ferrand University, 28 Place Henri Dunant, 63000, Clermont-Ferrand, France.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Eschalier
authors.affiliation: Cardiology Department, Clermont-Ferrand University Hospital, 58 Rue Montalembert, 63000, Clermont-Ferrand, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Vorilhon
authors.affiliation: Cardiology Department, Clermont-Ferrand University Hospital, 58 Rue Montalembert, 63000, Clermont-Ferrand, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Eschalier
authors.affiliation: General Practice Department, Faculty of Medicine of Clermont-Ferrand University, 28 Place Henri Dunant, 63000, Clermont-Ferrand, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Clément
authors.affiliation: General Practice Department, Faculty of Medicine of Tours University, 10 boulevard Tonnellé, 37032, Tours, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Pouchain
authors.affiliation: Department of General Practice, Institute of Community Medicine, University of Greifswald, Fleischmannstr. 42-44, 17475, Greifswald, Germany.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Chenot
authors.affiliation: Clinical Investigation Center, INSERM CIC 1401, Clermont-Ferrand University Hospital, 58 Rue Montalembert, 63000, Clermont-Ferrand, France.
authors.forename: Claude
authors.initials: C
authors.lastname: Dubray
authors.affiliation: General Practice Department, Faculty of Medicine of Clermont-Ferrand University, 28 Place Henri Dunant, 63000, Clermont-Ferrand, France.|Clermont University, University of Auvergne, EA 4681, PEPRADE (Périnatalité, grossesse, Environnement, PRAtiques médicales et DEveloppement), Clermont-Ferrand, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Vorilhon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D058006:General Practice; D006304:Health Status; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010353:Patient Education as Topic; D011320:Primary Health Care; D011788:Quality of Life; D013318:Stroke Volume; D011795:Surveys and Questionnaires
keywords: Cluster randomised controlled trial; Heart failure; Patient education; Primary care; Quality of life